The influence of physical exercise and leisure activity on neuropsychological functioning in older adults

The effectiveness of real-life cognitive and physical interventions on cognitive functioning in healthy older adults: A systematic review of the effects of education and training duration

Physical and cognitive interventions are deemed the primary methods of improving cognitive functioning in healthy older adults. However, the effectiveness of these interventions is still debated. This systematic review, synthesised findings from the literature on four different types of interventions: physical activities, cognitive training, cognitive stimulation and a combined intervention. We searched six databases for each intervention category. Findings demonstrated that 65% of the studies across all intervention groups reported improvement in the experimental group following the intervention. Furthermore, memory, executive and global cognitive functions were the most reported improvements post-intervention. Additionally, participants with higher education benefited more from cognitive training (an intervention that targets a specific cognitive domain), while those with lower education gained more following cognitive stimulation (an intervention that targets general domains). Lastly, in sub-types of physical activity, cognitive stimulation and combined category, longer durations (more than 20 sessions) were associated with significant cognitive improvements. Conversely, in cognitive training, having less than 20 sessions led to significant results. Findings indicated an interaction of education and intervention duration with significant outcomes post-intervention. In conclusion, this review demonstrated the importance of intervention type, duration and education in understanding cognitive improvement post-intervention.

Effect of the ActivaMotricidad Program on Improvements in Executive Functions and Interpersonal Relationships in Early Childhood Education

Background: The objective of this study was to analyze the impacts of a comprehensive physical exercise program with cognitive involvement during the school day on the executive functions and interpersonal skills of 5- and 6-year-old children. Methods: A total of 68 children participated in a 3-week pre-post intervention. Results: The results showed significant improvements in executive functions and interpersonal skills under the experimental conditions compared to the control group. These positive effects were observed to persist after a three-week follow-up. Conclusions: Therefore, the ActivaMotricidad program, which focuses on developing fundamental motor skills through cognitive, cooperative, and coordinative challenges, can serve as a useful and low-cost tool to achieve the objectives of comprehensive development and sustainability for children in early childhood education.

Effect of moderate-intensity aquatic treadmill exercise on cognitive function and cerebral blood flow for healthy older adults

To compare the effect of moderate-intensity aquatic treadmill exercise (ATM) on cerebral blood flow (CBF) and cognitive function in healthy older adults to that of moderate-intensity land-based treadmill exercise (LTM). This randomized controlled trial study was conducted between May 2023 and Oct 2023. Twenty-eight participants aged 60-80 were randomly assigned to either ATM group (N = 14) or LTM group (N = 14). Cognitive function and cerebral blood flow were assessed before and after the exercise. The outcome measures used in this study were the Digit Symbol Substitution Test (DSST) and the Digit Span Test (DST) to assess cognitive performance, and the mean middle cerebral artery blood velocity (MCAvmean) to evaluate CBF. A mixed effects model was used to analyze the within-group and between-group differences in cognitive function and CBF outcomes pre-to-post treadmill by SPSS. The DSST demonstrated a statistically significant improvement within both the ATM [β ± SE: -13.643 ± 2.407, 95 % CI: -18.749, -8.537] and LTM [β ± SE: -19.25 ± 3.66, 95 % CI: -26.424, -12.076] groups, indicating clinical significance in both groups. Both ATM and LTM groups exhibited post-exercise improvements within their respective groups for forward Digit Span Test (FDST) [ATM β ± SE: -0.143 ± 0.362, 95 % CI: -0.92, 0.634; LTM β ± SE: -0.286 ± 0.37, 95 % CI: -1.078, 0.506] and backward Digit Span Test (BDST) (ATM β ± SE: -1.741 ± 5.377, 95 % CI: -13.27, 9.792; LTM β ± SE: -6.729 ± 5.370, 95 % CI: -4.788, 18.24). In terms of MCAvmean, there is a higher improvement of CBF in ATM group [β ± SE: -138.669 ± 67.9217, 95 % CI: -288.164, 10.826] than LTM group [β ± SE: -9.305 ± 70.076, 95 % CI: -153.617, 135.007]. Hence, a single bout of moderate-intensity ATM and LTM can enhance cognitive function and CBF in healthy older adults, suggesting their potential as preventive strategies against age-related declines.

Long-Term Improvement in Hippocampal-Dependent Learning Ability in Healthy, Aged Individuals Following High Intensity Interval Training

Physical exercise may reduce dementia risk in aging, but varying reports on its effectiveness make it challenging to ascribe what level of exercise will have significant longer-term effects on important functions such as hippocampal-based learning and memory. This study compared the effect of three different 6-month exercise regimens on hippocampal-dependent cognition in healthy, elderly individuals. Participants, aged 65-85 with no cognitive deficits, were randomly assigned to one of three exercise interventions (low (LIT), medium (MIT), and High intensity interval training (HIIT), respectively). Each participant attended 72 supervised exercise sessions over a 6-month period. A total of 151 participants completed all sessions. Cognitive testing for hippocampal performance occurred monthly, as did blood collection, and continued for up to 5 years following initiation of the study. Multimodal 7 Tesla MRI scans were taken at commencement, 6 and 12 months. After 6 months, only the HIIT group displayed significant improvement in hippocampal function, as measured by paired associative learning (PAL). MRI from the HIIT group showed abrogation of the age-dependent volumetric decrease within several cortical regions including the hippocampus and improved functional connectivity between multiple neural networks not seen in the other groups. HIIT-mediated changes in the circulating levels of brain-derived neurotrophic factor (BDNF) and cortisol correlated to improved hippocampal-dependent cognitive ability. These findings demonstrate that HIIT significantly improves and prolongs the hippocampal-dependent cognitive health of aged individuals. Importantly, improvement was retained for at least 5 years following initiation of HIIT, suggesting that the changes seen in hippocampal volume and connectivity underpin this long-term maintenance. Sustained improvement in hippocampal function to this extent confirms that such exercise-based interventions can provide significant protection against hippocampal cognitive decline in the aged population. The changes in specific blood factor levels also may provide useful biomarkers for choosing the optimal exercise regimen to promote cognitive improvement.

The Association Between Physical Activity, Obesity, and Cognition in Middle-Aged and Older Adults

As rates of obesity continue to rise, so does the impact of obesity on cognitive function. Engaging in physical activity is one pathway through which individuals can help maintain cognitive function. This study examined whether any link between exercise and cognitive function was associated with weight characteristics. Data from 6,012 participants in the Health and Retirement Study were used. The association between participation in light or moderate physical activity and better cognitive function was particularly strong for overweight or obese adults and less so for those who were normal weight. Overall, the findings suggested that while being physically active is associated with better cognitive function regardless of weight, the associations were stronger for individuals who were overweight/obese compared with those who were normal weight. Given the results were particularly pronounced for waist circumference (relative to body mass index), further research should be conducted to examine if individuals with greater abdominal adiposity may benefit most from staying active in terms of their cognitive function.

Physical activity on executive function in sedentary individuals: Systematic review and meta-analysis of randomized controlled trials

Physical activity has been demonstrated to promote cognitive performance. However, the relationship between physical activity and executive function (EF) in sedentary individuals is not fully understood. This meta-analysis examined the impact of physical activity on EF in sedentary individuals and evaluated potential moderators of the relationship between physical activity and EF. In accordance with the PRISMA guidelines, the electronic databases MEDLINE, Embase, PsycINFO and Web of Science were searched. Included studies had to report sedentary individuals randomized to either a physical activity group or a control group. Subgroup analyses of EF sub-domains, exercise prescription and age were conducted alongside the overall meta-analysis. Thirteen RCT studies were included, with a total of 752 participants. Results showed a small to moderate beneficial effect of physical activity on EF (SMD = 0.24, 95% CI 0.08 to 0.40). In subgroup analysis by EF sub-domains, physical activity enhanced inhibitory control (SMD = 0.38, 95% CI 0.12 to 0.63) and working memory (SMD = 0.22, 95% CI -0.05 to 0.49), but not cognitive flexibility (SMD = 0.11, 95% CI -0.18 to 0.41). Interventions with an intervention length > 12 weeks improved overall EF (SMD = 0.26, 95% CI 0.06 to 0.46), but intervention length ≤ 12 weeks did not (SMD = 0.20, 95% CI -0.08 to 0.47). Interventions with session time ≥ 45 minutes improved overall EF (SMD = 0.47, 95% CI 0.22 to 0.77), but session time < 45 minutes did not (0.17, 95% CI -0.11 to 0.44). Physical activity improves EF for older adults (age ≥ 60 years) (SMD = 0.25, 95% CI 0.08 to 0.42), but not for younger individuals (age < 60 years) (SMD = 0.17, 95% CI -0.25 to 0.59). Overall, physical activity has a beneficial effect on EF in sedentary individuals, although the influence may be domain specific and influenced by exercise prescription and age. These findings have practical implications for those seeking to improve EF in sedentary individuals through physical activity.

The cognitive benefits of basketball training compared to a combined endurance and resistance training regimen: a four-month intervention study

Neurocognitive function, especially executive functioning, is positively associated with better fitness or higher levels of physical activity (PA). Previous research suggests that combined endurance and resistance (AER+R) training leads to greater improvements than training in either modality separately. Dynamic team sports with cognitive dimensions, such as basketball (BAS), may be an excellent context for improving cognition. This study compared the effects of following a four-month PA training program in BAS versus AER+R on executive functions along with a control group with low PA. Fifty participants completed the training period and were randomly distributed into three groups: BAS (16 participants), AER+R (18), and control (16). Participants in the BAS group showed improved inhibition and working memory and those in the AER+R group showed improved inhibition and cognitive flexibility, while inhibition deteriorated in the control group. There were significant differences between groups only in inhibition. It appears that following a four-month PA training program is enough to enhance executive functioning, and improvements in inhibition are more evident when the program includes an open sport such as BAS.

The Effects of Exercise for Cognitive Function in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Physical exercise can slow down the decline of the cognitive function of the older adults, yet the review evidence is not conclusive. The purpose of this study was to compare the effects of aerobic and resistance training on cognitive ability.

METHODS

A computerized literature search was carried out using PubMed, Cochrane Library, Embase SCOPUS, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang, and VIP database to identify relevant articles from inception through to 1 October 2022. Based on a preliminary search of the database and the references cited, 10,338 records were identified. For the measured values of the research results, the standardized mean difference (SMD) and 95% confidence interval (CI) were used to synthesize the effect size.

RESULTS

Finally, 10 studies were included in this meta-analysis. Since the outcome indicators of each literature are different in evaluating the old cognitive ability, a subgroup analysis was performed on the included literature. The study of results suggests that aerobic or resistance training interventions significantly improved cognitive ability in older adults compared with control interventions with the Mini-Mental State Examination (MD 2.76; 95% CI 2.52 to 3.00), the Montreal Cognitive Assessment (MD 2.64; 95% CI 2.33 to 2.94), the Wechsler Adult Intelligence Scale (MD 2.86; 95% CI 2.25 to 3.47), the Wechsler Memory Scale (MD 9.33; 95% CI 7.12 to 11.54), the Wisconsin Card Sorting Test (MD 5.31; 95% CI 1.20 to 9.43), the Trail Making Tests (MD -8.94; 95% CI -9.81 to -8.07), and the Stroop Color and Word Test (MD -5.20; 95% CI -7.89 to -2.51).

CONCLUSION

Physical exercise improved the cognitive function of the older adults in all mental states. To improve cognitive ability, this meta-analysis recommended that patients perform at least moderate-intensity aerobic exercise and resistance exercise on as many days as possible in the week to comply with current exercise guidelines while providing evidence for clinicians.

Aerobic physical activity to improve memory and executive function in sedentary adults without cognitive impairment: A systematic review and meta-analysis

The worldwide population of adults ages 50 and older continues to increase and is projected to reach over 2.3 billion by 2030. Aging is the biggest risk factor for cognitive impairment and dementia. Aerobic physical activity may improve cognitive functioning, thus delaying aging-related cognitive decline. The purpose of this review was to examine the effect of aerobic physical activity on memory and executive function in sedentary adults with no known cognitive impairment. PubMed, CINAHL, Psycinfo, and Cochrane Library databases were systematically searched for peer-reviewed articles up to July 2019. Randomized controlled trials of sedentary adults, aged 50 and older, that compared an aerobic physical activity intervention to either no treatment or alternative active comparator and reported outcome measures of memory and/or executive function were included. A random effects meta-analysis was performed to examine the separate effect sizes for memory and executive function. Nine studies met inclusion criteria and contributed either memory and/or executive function effect sizes (n = 547). Results from the random effects meta-analysis suggested, by post-intervention, a large effect size for the aerobic physical activity interventions on memory (g = 0.80, 95%CI: 0.14-1.47; n = 7; p = 0.02) and a small effect on executive function (g = 0.37, 95%CI: 0.04-0.69; n = 6; p = 0.03). Aerobic physical activity may improve memory and executive function in sedentary adults without cognitive impairment. Policymakers and providers should promote aerobic physical activity in this population, and further research should investigate the most effective ways to promote aerobic physical activity in mid-life to older adults.

Physical Inactivity is Liable to the Increased Cardiovascular Risk and Impaired Cognitive Profile

BACKGROUND

Sedentary life-style is a significant public health issue. It increases the incidence of type-2 diabetes mellitus (DM2) and systemic arterial hypertension (SAH), which in turn may impair physical and mental health. In fact, disrupted glucose metabolism is characteristic of Alzheimer's dementia, and it is often dubbed as type-3 diabetes.

OBJECTIVE

The purpose of this study was to assess the level of activity, body composition, cardiovascular risk and cognitive profile of patients with DM2 and/or SAH. The study was cross-sectional design.

METHOD

The sample consisted of 120 individuals which 35% men and 65% women, with an average of 64±9 years old and 60±11 years old, respectively. Various parameters were evaluated such as anthropometric variables, pedometer recordings and brief cognitive screening battery (BCSB), which assesses the immediate memory, verbal fluency, learning, late memory and recognition. Chi-square and Fisher's exact test were applied to observe possible differences between men and women. In addition to Kruskall-Wallis, in the comparison between patients with SAH; DM2 and SAH + DM2.

RESULTS

A high rate of physical inactivity was found among those enrolled in this project. Females were characterized by increased body fat, whereas men displayed visceral fat excess. BCSB demonstrated reduced verbal fluency, late memory and recognition, with women presenting significantly worse results.

CONCLUSION

Low level of daily physical activity is apparently correlated with obesity, elevated cardiovascular risk, and cognitive dysfunction.

The Influence of the Physiotherapeutic Program on Selected Static and Dynamic Foot Indicators and the Balance of Elderly Women Depending on the Ground Stability

Seniors are a constantly growing group of people in many societies. It is necessary to develop physiotherapeutic programs to improve their mobility. The aim of this study was to assess the impact of the physiotherapeutic program conducted unstable ground on selected indicators of motor functions of elderly women. Sixty women (60–80 years) participated in the research. Group A (N = 20) underwent a 12-week physiotherapeutic program on stable ground, group B (N = 20) followed an exercise program on unstable ground, and group C (N = 20) (control group) had no therapeutic intervention. The effects of the therapy were assessed by using a FreeMed platform (foot load analysis) and a Biosway balance system. The results were compared using ANOVA (the one-way analysis), the Kruskal–Wallis test and also the post hoc tests (Tukey’s test and the multiple comparison test). In group A, a statistically significant change was observed in the static test and balance assessment, in group B this was observed in the static and dynamic foot tests and balance assessment, in group C, no statistical significance was achieved. The authors’ physiotherapeutic program had a statistically significant effect on changes in the balance and selected indicators of the motor functions of the examined people. Comparing the results before and after the therapy more improvement changes were noted in women training on an unstable ground compared to women training on a stable ground.

Characteristics of Physical Exercise Programs for Older Adults in Latin America: A Systematic Review of Randomized Controlled Trials

AIM

To characterize physical exercise programs for older adults in Latin America.

METHODS

This review was conducted in accordance with the PRISMA statement. A search for randomized controlled trials (RCTs) published between the years 2015 and 2020 was performed in the Scopus, MedLine and SciELO databases.

RESULTS

A total of 101 RCTs were included. A large percentage of the studies had an unclear risk of bias in the items: selection, performance, detection and attribution. Furthermore, a heterogeneous level of compliance was observed in the CERT items. A total sample of 5013 older adults (79% women) was included. 97% of the studies included older adults between 60-70 years, presenting an adherence to the interventions of 86%. The studies were mainly carried out in older adults with cardiometabolic diseases. Only 44% of the studies detailed information regarding the place of intervention; of these studies, 61% developed their interventions in university facilities. The interventions were mainly based on therapeutic physical exercise (89% of the articles), with a duration of 2-6 months (95% of the articles) and a frequency of 2-3 times a week (95% of the articles) with sessions of 30-60 min (94% of the articles) led by sports science professionals (51% of the articles). The components of physical fitness that were exercised the most were muscular strength (77% of the articles) and cardiorespiratory fitness (47% of the articles). Furthermore, only 48% of the studies included a warm-up stage and 34% of the studies included a cool-down stage.

CONCLUSIONS

This systematic review characterized the physical exercise programs in older adults in Latin America, as well the most frequently used outcome measures and instruments, by summarizing available evidence derived from RCTs. The results will be useful for prescribing future physical exercise programs in older adults.

Promoting Successful Cognitive Aging: A Ten-Year Update

A decade has passed since we published a comprehensive review in this journal addressing the topic of promoting successful cognitive aging, making this a good time to take stock of the field. Because there have been limited large-scale, randomized controlled trials, especially following individuals from middle age to late life, some experts have questioned whether recommendations can be legitimately offered about reducing the risk of cognitive decline and dementia. Despite uncertainties, clinicians often need to at least make provisional recommendations to patients based on the highest quality data available. Converging lines of evidence from epidemiological/cohort studies, animal/basic science studies, human proof-of-concept studies, and human intervention studies can provide guidance, highlighting strategies for enhancing cognitive reserve and preventing loss of cognitive capacity. Many of the suggestions made in 2010 have been supported by additional research. Importantly, there is a growing consensus among major health organizations about recommendations to mitigate cognitive decline and promote healthy cognitive aging. Regular physical activity and treatment of cardiovascular risk factors have been supported by all of these organizations. Most organizations have also embraced cognitively stimulating activities, a heart-healthy diet, smoking cessation, and countering metabolic syndrome. Other behaviors like regular social engagement, limiting alcohol use, stress management, getting adequate sleep, avoiding anticholinergic medications, addressing sensory deficits, and protecting the brain against physical and toxic damage also have been endorsed, although less consistently. In this update, we review the evidence for each of these recommendations and offer practical advice about behavior-change techniques to help patients adopt brain-healthy behaviors.

Revisiting the role of neurotransmitters in epilepsy: An updated review

Epilepsy is a neurologicaldisorder characterized by persistent predisposition to recurrent seizurescaused by abnormal neuronal activity in the brain. Epileptic seizures maydevelop due to a relative imbalance of excitatory and inhibitory neurotransmitters. Expressional alterations of receptors and ion channelsactivated by neurotransmitters can lead to epilepsy pathogenesis.

AIMS

In this updated comprehensive review, we discuss the emerging implication of mutations in neurotransmitter-mediated receptors and ion channels. We aim to provide critical findings of the current literature about the role of neurotransmitters in epilepsy.

MATERIALS AND METHODS

A comprehensive literature review was conducted to identify and critically evaluate studies analyzing the possible relationship between epilepsy and neurotransmitters. The PubMed database was searched for related research articles.

KEY FINDINGS

Glutamate and gamma-aminobutyric acid (GABA) are the main neurotransmitters playing a critical role in the pathophysiology of this balance, and irreversible neuronal damage may occur as a result of abnormal changes in these molecules. Acetylcholine (ACh), the main stimulant of the autonomic nervous system, mediates signal transmission through cholinergic and nicotinic receptors. Accumulating evidence indicates that dysfunction of nicotinic ACh receptors, which are widely expressed in hippocampal and cortical neurons, may be significantly implicated in the pathogenesis of epilepsy. The dopamine-norepinephrine-epinephrine cycle activates hormonal and neuronal pathways; serotonin, norepinephrine, histamine, and melatonin can act as both hormones and neurotransmitters. Recent reports have demonstrated that nitric oxide mediates cognitive and memory-related functions via stimulating neuronal transmission.

SIGNIFICANCE

The elucidation of the role of the main mediators and receptors in epilepsy is crucial for developing new diagnostic and therapeutic approaches.

Physical exercise and 5-hydroxytryptophan, a precursor for serotonin synthesis, reduce penicillin-induced epileptiform activity

AIM

Previous studies have shown that 5- hydroxytryptophan (5-HTP) and exercise play an important role in the synthesis of serotonin independently. The effects of the treadmill exercise and 5- hydroxytryptophan (5-HTP) on seizure mechanisms created by epileptiform activity with penicillin model were investigated in rats.

METHOD

A total of 28 male albino Wistar rats were randomly divided into four groups: exercise (Ex), Control (Cnt), 5-hydroxytryptophan (5htp) and 5-hydroxytryptophan + exercise (5htpEx) groups. Treadmill exercise and gavage (25 mg/kg/day) were administered five days a week for ten weeks. Electrocorticogram data were recorded for 3 h at the end of the protocol using the Power-Lab data acquisition system. Spike frequency, amplitude, and latency time were analyzed offline. The significant differences among the groups were evaluated by one-way analysis of variance (ANOVA).

RESULTS

Spike frequency was observed at the highest level from the 20th minute in the Cnt group, and this continued until the end of the recording. The 5-HTP alone group did not affect epileptiform activity. At the 80th minute of penicillin injection, the epileptiform activity in the 5htpEx group decreased significantly compared with the Cnt, and this significance continued until the 110th minute. There was no statistical difference in the amplitude values of the groups. The 5htpEx group was significantly higher than both the Cnt and Ex group in the seizure latency times.

CONCLUSIONS

It was determined that exercise reduced the spike number and delayed seizure significantly by potentiating the effect of 5-HTP. Given that 5-HTP used in combination with exercise can perform useful actions such as reducing seizure sensitivity and consequently improving the quality of life for individuals with epilepsy, it may be a potential candidate for the treatment of epilepsy in nonpharmacological methods.

Efficacy of lifestyle and psychosocial interventions in reducing cognitive decline in older people: Systematic review

It is unclear what non-pharmacological interventions to prevent cognitive decline should comprise. We systematically reviewed lifestyle and psychosocial interventions that aimed to reduce cognitive decline in healthy people aged 50+, and people of any age with Subjective Cognitive Decline or Mild Cognitive Impairment. We narratively synthesised evidence, prioritising results from studies rated as at lower Risk of Bias (ROB) and assigning Centre for Evidence Based Medicine grades. We included 64 papers, describing: psychosocial (n = 12), multi-domain (n = 10), exercise (n = 36), and dietary (n = 6) interventions. We found Grade A evidence that over 4+ months: aerobic exercise twice weekly had a moderate effect on global cognition in people with/ without MCI; and interventions that integrate cognitive and motor challenges (e.g. dance, dumb bell training) had small to moderate effects on memory or global cognition in people with MCI. We found Grade B evidence that 4+ months of creative art or story-telling groups in people with MCI; 6 months of resistance training in people with MCI and a two-year, dietary, exercise, cognitive training and social intervention in people with or without MCI had small, positive effects on global cognition. Effects for some intervention remained up to a year beyond facilitated sessions.

ABCA7 Genotype Moderates the Effect of Aerobic Exercise Intervention on Generalization of Prior Learning in Healthy Older African Americans

African Americans are at elevated risk for age-related cognitive decline, with double the prevalence of Alzheimer's disease (AD) compared to Caucasians Americans. Various behavioral, biological, and lifestyle factors may underlie this health disparity, but little is known about the relative importance and interactions among these different risk factors in African Americans. While the neuroprotective effects of aerobic exercise on biomarkers are well established, few studies have examined the differential benefits of exercise based on genetic risk for AD. Furthermore, evidence is limited regarding the potential moderating effects of ABCA7, a gene known to confer significantly greater AD risk in African Americans. In a case-control matched sample of 56 healthy older African Americans, we investigated the effect of an aerobic exercise intervention on a hippocampus-related assessment of generalization following rule learning, in individuals who were carriers of the ABCA7 rs3764650 non-risk (TT) or high-risk (GG) genotype. Following the exercise-intervention, the non-risk group made significantly fewer generalization errors, while there was no improvement in generalization for the high-risk group. For the controls, no changes in generalization scores were observed regardless of genotype status. Our results indicate that the ongoing adverse effects of ABCA7 high-risk genotype may diminish the benefits associated with aerobic exercise. As such, the potential disease-modifying effects of aerobic exercise on AD-related neuropathology may be limited to carriers of the ABCA7 rs3764650 non-risk genotype.

Impact of exercise training on physical and cognitive function among older adults: a systematic review and meta-analysis

Exercise plays a key role in healthy aging by promoting both physical and cognitive function. Physical function and cognitive function appear to be interrelated and may share common mechanisms. Thus, exercise-induced improvements in physical function and cognitive function may co-occur and be associated with each other. However, no systematic review has specifically assessed and compared the effects of exercise on both physical function and cognitive function in older adults, and the association between changes in both outcomes after exercise training. Thus, we conducted a systematic review and meta-analysis (N = 48 studies) among older adults (60+ years). These data suggest exercise training has a significant benefit for both physical function (g = 0.39; p < 0.001) and cognitive function (g = 0.24; p < 0.001). At the study level, there was a positive correlation between the size of the exercise-induced effect on physical function and on cognitive function (b = 0.41; p = 0.002). Our results indicate exercise improves both physical and cognitive function, reiterating the notion that exercise is a panacea for aging well.

Effects of physical activity on delayed memory measures in randomized controlled trials with nonclinical older, mild cognitive impairment, and dementia participants

INTRODUCTION

Longitudinal studies have found that physical activity protects against Alzheimer disease, but the mechanism is unknown. The prevailing model derives from animal research and has physical activity directly affecting brain physiology by increasing brain volume, brain-derived neurotrophic factor (BDNF), and hippocampal neurogenesis with consequent gains in neuropsychological test scores. Supporting evidence has been mixed, with physical-activity-related gains across multiple neuropsychological domains considered indicative of the protective effect. Hippocampal-mediated delayed memory functioning is the first neurocognitive skill to be impaired in the early stages of Alzheimer disease, and physical-activity-related gains on delayed memory measures would provide the strongest support for the model.

RESULTS

Review of 26 randomized controlled trials with nonclinical older, mild cognitive impairment, and dementia participants found only one with significant physical-activity-related gains in delayed memory compared to controls. This evidence does not support the physiological brain change model. Similarly, there is questionable support from those randomized controlled trials that have measured physical-activity-related brain volume and blood BDNF levels (neurogenesis having no valid labeling technique in living humans).

CONCLUSION

Physical-activity-related protective effects against Alzheimer disease are likely mediated through pathways outside the central nervous system.

Sex differences in exercise efficacy to improve cognition: A systematic review and meta-analysis of randomized controlled trials in older humans

Exercise is a non-pharmacological strategy to mitigate the deleterious effects of aging on brain health. However, a large amount of variation exists in its efficacy. Sex of participants and exercise type are two possible factors contributing to this variation. To better understand this, we conducted a concurrent systematic review and meta-analysis of cognitively healthy older adults. Executive functions, episodic memory, visuospatial function, word fluency, processing speed and global cognitive function were examined for exercise- and sex-dependent effects. For executive functions, three types of exercise interventions - aerobic training, resistance training, and multimodal training (i.e., both aerobic and resistance training) - were associated with larger effect sizes in studies comprised of a higher percentage of women compared to studies with a lower percentage of women. This suggests that women's executive processes may benefit more from exercise than men. Regardless of sex, compared to control, all three exercise training approaches enhanced visuospatial function, but only multimodal training enhanced episodic memory. Overall, aerobic training led to greater benefits than resistance training in global cognitive function and executive functions, while multimodal combined training led to greater benefits than aerobic training for global cognitive function, episodic memory, and word fluency. Possible underlying mechanisms, including brain-derived neurotrophic factor and sex steroid hormones, are discussed.

Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis

Background

Physical exercise is seen as a promising intervention to prevent or delay cognitive decline in individuals aged 50 years and older, yet the evidence from reviews is not conclusive.

Objectives

To determine if physical exercise is effective in improving cognitive function in this population.

Design

Systematic review with multilevel meta-analysis.

Data sources

Electronic databases Medline (PubMed), EMBASE (Scopus), PsychINFO and CENTRAL (Cochrane) from inception to November 2016.

Eligibility criteria

Randomised controlled trials of physical exercise interventions in community-dwelling adults older than 50 years, with an outcome measure of cognitive function.

Results

The search returned 12 820 records, of which 39 studies were included in the systematic review. Analysis of 333 dependent effect sizes from 36 studies showed that physical exercise improved cognitive function (0.29; 95% CI 0.17 to 0.41; p<0.01). Interventions of aerobic exercise, resistance training, multicomponent training and tai chi, all had significant point estimates. When exercise prescription was examined, a duration of 45–60 min per session and at least moderate intensity, were associated with benefits to cognition. The results of the meta-analysis were consistent and independent of the cognitive domain tested or the cognitive status of the participants.

Conclusions

Physical exercise improved cognitive function in the over 50s, regardless of the cognitive status of participants. To improve cognitive function, this meta-analysis provides clinicians with evidence to recommend that patients obtain both aerobic and resistance exercise of at least moderate intensity on as many days of the week as feasible, in line with current exercise guidelines.

Erfolgreiches kognitives Altern: Zusammenhang der kognitiven Leistungen mit Aktivität und Zufriedenheit

Zusammenfassung. Für erfolgreiches Altern sind Kognition, Zufriedenheit und tägliche Aktivitäten relevante Faktoren. In dieser Studie werden Zusammenhänge zwischen diesen Faktoren aufgedeckt. Bei 167 Senioren (60 bis 98 Jahre) wurden Aktivität und Zufriedenheit in einem Interview, Kognition durch die Neuropsychological Assessment Battery (dt. Version) erfasst. Alle Faktoren zeigen eine negative Altersentwicklung. Aktivitäten korrelieren mit allen Faktoren; insbesondere stehen Alltagsaktivitäten und kognitive Aktivitäten positiv mit Kognition im Zusammenhang, soziale Aktivität ist davon unabhängig. Die kognitiven Funktionsbereiche Aufmerksamkeit, Sprache und exekutive Funktionen variieren mit Aktivität und Zufriedenheit, Gedächtnis nur mit kognitiven Aktivitäten, Wahrnehmung ist davon unabhängig. Dies könnte bedeuten, dass kognitive Aktivitäten spezifisch mit der kognitiven Leistung und soziale Aktivitäten spezifisch mit der emotionalen Bewertung zusammenhängen und als Schutzfaktoren während der Entwicklung wirken könnten.

Computer-based tools for assessing micro-longitudinal patterns of cognitive function in older adults

Patterns of cognitive change over micro-longitudinal timescales (i.e., ranging from hours to days) are associated with a wide range of age-related health and functional outcomes. However, practical issues of conducting high-frequency assessments make investigations of micro-longitudinal cognition costly and burdensome to run. One way of addressing this is to develop cognitive assessments that can be performed by older adults, in their own homes, without a researcher being present. Here, we address the question of whether reliable and valid cognitive data can be collected over micro-longitudinal timescales using unsupervised cognitive tests.In study 1, 48 older adults completed two touchscreen cognitive tests, on three occasions, in controlled conditions, alongside a battery of standard tests of cognitive functions. In study 2, 40 older adults completed the same two computerized tasks on multiple occasions, over three separate week-long periods, in their own homes, without a researcher present. Here, the tasks were incorporated into a wider touchscreen system (Novel Assessment of Nutrition and Ageing (NANA)) developed to assess multiple domains of health and behavior. Standard tests of cognitive function were also administered prior to participants using the NANA system.Performance on the two "NANA" cognitive tasks showed convergent validity with, and similar levels of reliability to, the standard cognitive battery in both studies. Completion and accuracy rates were also very high. These results show that reliable and valid cognitive data can be collected from older adults using unsupervised computerized tests, thus affording new opportunities for the investigation of cognitive.