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Chronic endurance exercise training prevents aging-related cognitive decline in healthy older adults: a randomized controlled trial
- Authors:
- MUSCARI Antonio, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(10), October 2010, pp.1055-1064.
- Publisher:
- Wiley
This study investigated the effects of endurance exercise training (EET) on the cognitive status of healthy community-dwelling older people in Pianoro, northern Italy. One hundred and twenty healthy subjects, aged 65 to 74 years, were randomised into treatment and control groups. The treatment consisted of 12 months of supervised EET in a community gym. All participants were assessed both at baseline and after 12 months. Cognitive status was assessed by the Mini Mental State Examination (MMSE). Anthropometric indexes, routine laboratory measurements and C-reactive protein (CRP) were also assessed. The control group showed a significant decrease in MMSE score, which differed significantly from the treatment group scores. The odds ratio for the treated older adults to have a stable cognitive status after 1 year, as compared to the control group, was 2.74 after adjustment for age, gender, educational level and several other possible confounders. Blood pressure, body mass index, waist circumference and serum cholesterol did not differ significantly between the two groups, while CRP decreased only in the treatment group. The authors concluded that a 12-month EET intervention may reduce the onset of age-related cognitive decline.
Physical activity and executive functions in the elderly with mild cognitive impairment
- Authors:
- SCHERDER E. J. A., et al
- Journal article citation:
- Aging and Mental Health, 9(3), May 2005, pp.272-280.
- Publisher:
- Taylor and Francis
This study aimed to examine whether in the elderly with mild cognitive impairment (MCI), the effect of physical activity measured directly following treatment, was reflected in an improvement in cognitive functioning in general or in executive functions (EF) in particular. The study also aimed to compare the effectiveness of two types of intervention, with varying intensities: walking and hand/face exercises. Forty-three frail, advanced elderly subjects (mean age: 86) with MCI were randomly divided into three groups: a walking group (n=15), a group performing hand and face exercises (n=13), and a control group (n=15). All subjects received individual treatment for 30-minutes a day, three times a week, for a period of six weeks. A neuropsychological test battery, administered directly after cessation of treatment, assessed cognitive functioning. The results show that although a (nearly) significant improvement in tasks appealing to EF was observed in both the walking group and the hand/face group compared to the control group, the results should be interpreted with caution. Firm conclusions about the effectiveness of mild physical activity on EF in the oldest old can only be drawn after studies with larger number of subjects.
Making physical activity accessible to older adults with memory loss: a feasibility study
- Authors:
- LOGSDON Rebecca G., et al
- Journal article citation:
- Gerontologist, 49(S1), June 2009, pp.S94-S99.
- Publisher:
- Oxford University Press
The Resources and Activities for Life Long Independence (RALLI) program in the US uses behavioural principles to make exercise more accessible for older people with memory loss. Exercises are broken into small steps, sequenced, and linked with cues to help participants remember them. Memory aids, easy-to-follow instructions, and tracking forms to facilitate adherence and proper technique are provided to enhance exercise training and compensate for memory loss. Thirty-seven individuals participated in RALLI pilot groups held in retirement residences. Attendance was excellent, with participants attending 90% of classes. At post-test (12 weeks), 84% of participants had exercised at least once during the prior week, compared with 62% who had exercised at least once during the week prior to baseline, mean exercise time increased by 156 min per week, and SF-36 physical components scale significantly improved. After 6 months, 76% of participants continued exercising and mean exercise time remained significantly improved. Persons with MCI can significantly benefit from an exercise program specifically designed to address their cognitive needs. Participants’ ratings indicate improvement in perceived physical health and emotional well-being as a result of the intervention. Thus, RALLI is a promising intervention to promote exercise in individuals with MCI.
Endurance and strength training outcomes on cognitively impaired and cognitively intact older adults: a meta-analysis
- Authors:
- HEYN P. C., JOHNSON K. E., KRAMER A. F.
- Journal article citation:
- Journal of Nutrition Health and Aging, 12(6), 2008, pp.401-409.
- Publisher:
- Springer
Nursing home residents are often viewed as too frail or cognitively impaired to be able to participate in or benefit from exercise rehabilitation, and those with a Mini Mental State Examination (MMSE) score of under 25 are frequently excluded from such programmes. This systematic review and meta-analysis identifies 41 randomised trials of exercise programmes: 21 conducted with cognitively impaired individuals (defined as MMSE scores of less than 25); and 20 with cognitively intact individuals (MMSE scores over 25). Moderate to large effect sizes were found for both groups, with no statistically significant differences between the two in respect of strength or endurance outcomes. The paper concludes that cognitively impaired people should not be excluded from exercise rehabilitation programmes.
Dual task walking costs in older adults with mild cognitive impairment: a systematic review and meta-analysis
- Authors:
- BISHNOI Alka, HERNANDEZ Manuel E.
- Journal article citation:
- Aging and Mental Health, 25(9), 2021, pp.1618-1629.
- Publisher:
- Taylor and Francis
Objective: The objective of this systematic review and meta-analysis (PROSPERO registration No CRD42020192121) is to review existing literature focusing on effects of different dual task paradigms on walking speed in older adults with and without Mild Cognitive Impairment. Methods: (1) Data Sources: PubMEd, Cumulative Index of Nursing and Allied Health, Cochrane library, and Web of Science. (2) Study Selection: The key terms searched included those associated with dual task, walking speed, executive function, older adults, and MCI. (3) Data Extraction: The search yielded 140 results with 20 studies meeting the inclusion criteria, which were rated by two independent reviewers using the Quality Assessment Tool. Descriptions of each study including the single and dual task protocol, outcome measure, and final outcomes were extracted. Meta-analysis was performed to evaluate the dual task effects on walking costs in older adults with and without MCI. Results: Meta-analysis revealed that there were significant differences in the dual task walking costs among older adults with or without MCI (p < .05). Pooled effect sizes of the serial subtraction (9.54; 95%CI, 3.93–15.15) and verbal fluency tasks (10.06; 95%CI, 6.26–15.65) showed that there are higher motor dual-task costs in older adults with MCI than age-matched controls. For quality assessment, all studies ranged from 12 to 16 in score, out of 18 (high quality). Conclusions: In the studies included in this review, mental tracking tasks, consisting of serial subtraction and verbal fluency, were found to be the most sensitive in detecting MCI-related changes in older adults, and could serve an important role as a target measure for evaluating the efficacy of interventions aimed at improving cognitive and motor function in older adults. (Edited publisher abstract)
Efficacy of exercise-based interventions in preventing falls among community-dwelling older persons with cognitive impairment: is there enough evidence? An updated systematic review and meta-analysis
- Authors:
- LI Fuzhong, et al
- Journal article citation:
- Age and Ageing, 50(5), 2021, pp.1557-1568.
- Publisher:
- Oxford University Press
Objective: Exercise prevents falls in the general older population, but evidence is inconclusive for older adults living with cognitive impairment. This study is an updated systematic review and meta-analysis to assess the potential effectiveness of interventions for reducing falls in older persons with cognitive impairment. Methods: PubMed, EMBASE, CINAHL, Scopus, CENTRAL and PEDro were searched from inception to 10 November 2020. This study included randomised controlled trials (RCTs) that evaluated the effects of physical training compared to a control condition (usual care, waitlist, education, placebo control) on reducing falls among community-dwelling older adults with cognitive impairment (i.e. any stage of Alzheimer’s disease and related dementias, mild cognitive impairment). Results: This study identified and meta-analysed nine studies, published between 2013 and 2020, that included 12 comparisons (N = 1,411; mean age = 78 years; 56% women). Overall, in comparison to control, interventions produced a statistically significant reduction of approximately 30% in the rate of falls (incidence rate ratio = 0.70; 95% CI, 0.52-0.95). There was significant between-trial heterogeneity (I2 = 74%), with most trials (n = 6 studies [eight comparisons]) showing no reductions on fall rates. Subgroup analyses showed no differences in the fall rates by trial-level characteristics. Exercise-based interventions had no impact on reducing the number of fallers (relative risk = 1.01; 95% CI, 0.90–1.14). Concerns about risk of bias in these RCTs were noted, and the quality of evidence was rated as low. Conclusions: The positive statistical findings on reducing fall rate in this meta-analysis were driven by a few studies. Therefore, current evidence is insufficient to inform evidence-based recommendations or treatment decisions for clinical practice. (Edited publisher abstract)
Multicomponent intervention combining a cognitive stimulation group and tai chi to reduce cognitive decline among community-dwelling older adults with probable dementia: a multi-center, randomized controlled trial
- Author:
- YOUNG Daniel Kim-Wan
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 19(6), 2020, pp.2073-2089.
- Publisher:
- Sage
Objective: This research study aims to evaluate the effectiveness of a multicomponent intervention that combines a cognitive stimulation group and tai chi to reduce cognitive decline among community-dwelling Chinese older adults with probable dementia. Methods: A multi-center, randomized controlled trial design was adopted in this study. In addition to treat as usual, the treatment group (n = 41) participated in a structured cognitive stimulation group followed by tai chi twice a week, with a total of 14 sessions held during the study period. The control group (n = 39) received treat as usual. Mattis Dementia Rating Scale and Mini-Mental State Examination were used for assessing the cognitive abilities of participants in the pre- and post-treatment periods. Results: A 2 × 2 repeated measures analysis of covariance demonstrated that the treatment group was more effective than the control group on improving Dementia Rating Scale score (F = 7.45, p < .01) with a moderate effect size (partial eta square = .09) and Mini-Mental State Examination score (F = 9.96, p < .01) with a moderate to large effect size (partial eta square = .12) after controlling for age, gender, educational level, marital status, and number of physical illnesses. Conclusion: The present study demonstrates the effectiveness of the multicomponent intervention on improving cognitive ability among community-dwelling older adults with probable dementia, suggesting that the multicomponent intervention can facilitate early identification, assessment, and treatment for community-dwelling older adults with probable dementia. (Edited publisher abstract)
Motor-cognitive effects of a computerized game-based training method in people with dementia: a randomized controlled trial
- Authors:
- Wiloth Stefanie, et al
- Journal article citation:
- Aging and Mental Health, 22(9), 2018, pp.1124-1135.
- Publisher:
- Taylor and Francis
Objectives: To examine the effects of a computerized, game-based training on motor-cognitive performances, the transfer of training effects on untrained tasks, and the sustainability of training gains in people with dementia. Method: Ninety-nine individuals with a mean age of 82.9 (5.8) and dementia participated in a 10-week randomized controlled trial with three-month follow-up. The intervention group (IG) received a motor-cognitive training on (Physiomat®) including concurrent dual-tasks of balance control with cognitive demands (Physiomat®-Trail Making Tasks (PTMTs)). The control group (CG) performed non-specific, low-intensity exercises. Duration and accuracy at different complexity levels of trained and untrained PTMTs and the number of successfully performed tasks (PTMT score) were assessed. Results: Physiomat® training significantly improved the duration and accuracy at almost all complexity levels of trained (P ≤ 0.001–0.047, ηp2 = 0.065–0.589) and untrained PTMTs (P < 0.001–0.005, ηp2 = 0.073–0.459). Significant effects were also found for the PTMT score of trained (P < 0.001, ηp2 = 0.211) and untrained PTMTs (P < 0.001, ηp2 = 0.184). Training gains were partly sustained at follow-up. Conclusion: Physiomat® is feasible and has the potential to sustainably improve motor-cognitive performances in people with dementia.
The brain-body connection: GCBH recommendations on physical activity and brain health
- Author:
- GLOBAL COUNCIL ON BRAIN HEALTH
- Publisher:
- Global Council on Brain Health
- Publication year:
- 2016
- Pagination:
- 17
Based on an examination of existing evidence and consensus of experts from a variety of disciplines, this paper presents key points on the relationship between exercise and brain health as we age. It also provides four recommendations, together with practical tips to help individuals put the recommendations into practice. The experts reached consensus on five points: physical activity has a positive impact on brain health; people can change their behaviour to become more physically active at any age; based on randomised controlled trials, people who participate in purposeful exercise show beneficial changes in brain structure and function; based on epidemiological evidence, people who lead a physically active lifestyle have lower risk of cognitive decline; and that there is not yet sufficient scientific evidence that physical activity can reduce risk of brain diseases that cause dementia. (Edited publisher abstract)
"Interactive surfaces" technology as a potential tool to stimulate physical activity in psychogeriatric nursing home residents
- Authors:
- BRAUN Susy M., et al
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 10(6), 2015, pp.486-492.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Purpose: This study aimed to determine whether and how psychogeriatric nursing home residents would respond to the interactive surfaces on the floor without receiving instructions and to determine how long residents would be physically active. Methods: The 'interactive surfaces' technology includes different graphic shapes that are projected through a beamer on a floor. The surfaces are 'activated' by a person’s movements in the area of the projection field, which is detected by an infrared camera. Every day for 1 h during an 11-day period one of seven different projections was shown. Spontaneous observed physical responses were counted, clustered and visualised in a tree diagram. Duration of physically responses was measured per session and during the total observation period of 11 h. Results: During 343 of 490 observations residents (n = 58) noticed the interactive surface and in 148 observations they engaged physically. In total, 4067 s (1 h, 7 min and 47 s) of physical activity were measured. Individual times that residents were active ranged from 3 to 415 s. Conclusions: Interactive surfaces technology may be a promising tool in psychogeriatric nursing home residents to stimulate physical activity. Further research is needed to assess its full potential. (Edited publisher abstract)