Multimodal Exercise and Cognitive Training Program Improves Cognitive Function in Amnestic Mild Cognitive Impairment

Nonpharmacological Multimodal Interventions for Cognitive Functions in Older Adults With Mild Cognitive Impairment: Scoping Review

BACKGROUND

As the global population ages, the prevalence of dementia is expected to rise significantly. To alleviate the burden on health care systems and the economy, it is essential to develop effective strategies to enhance cognitive function in older adults. Previous studies have shown that combined nonpharmacological interventions can improve cognition across various domains in older individuals. However, there is no established gold standard for the exact combination and duration of these interventions, which makes it challenging to assess their overall effectiveness.

OBJECTIVE

Given the diversity of nonpharmacological multimodal interventions aimed at preventing cognitive decline in older adults with mild cognitive impairment (MCI), this scoping review sought to identify and summarize the characteristics and outcomes of these interventions.

METHODS

We adhered to the Arksey and O'Malley methodological framework and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) and searched 4 electronic databases (MEDLINE, PsycINFO, CINAHL, and Web of Science) systematically on July 6, 2023, and updated the search on April 17, 2024, using specific terms and keywords.

RESULTS

This review included 45 studies from 18 countries with 4705 participants from 2014 to 2024 encompassing different combinations of physical training (PT), cognitive training (CT), nutrition intervention, psychosocial intervention, social activities, and electrical stimulation. There is a growing numbers of studies combining PT and CT for MCI treatment, with additional modalities often added to address various aspects of the condition. Compared to single-modal interventions and usual care, multimodal approaches demonstrated significantly better improvements in cognition domains such as attention, global cognition, executive function, memory, processing speed, and verbal fluency. Technology has been instrumental in delivering these interventions and enhancing the effects of PT and CT. Multimodal interventions also show promise in terms of acceptability and user experience, which can improve treatment adherence.

CONCLUSIONS

Research is limited regarding the cost-effectiveness and optimal dosage of these interventions, making it difficult to assess the additional benefits of incorporating more modalities. Future research should examine the long-term effects of incorporating multiple modalities, using standardized MCI criteria and outcome measures.

Associations of exercise snacks with cognitive function among older adults in NHANES 2011-2014

BACKGROUND

With an aging global population, dementia incidence is rapidly increasing, affecting 50 million people worldwide. While physical activity has been linked to cognitive enhancement, the specific effects of intermittent short bouts of exercise, termed 'exercise snacks' (ES), on cognitive function (CF) in older adults are not well understood.

METHODS

We analyzed data from 2549 adults aged ≥60 years from the 2011-2014 National Health and Nutrition Examination Survey cycles. CF was assessed using standardized tests, and physical activity data were obtained from accelerometer measurements. ES was defined as 2-5 min of moderate-to-vigorous physical activity. Regression analyses, smoothed curve fitting, and threshold effect analyses were conducted, adjusting for relevant covariates.

RESULTS

Significant positive associations were found between CF and daily average Monitor-Independent Movement Summary specific to ES (MIMS-ES: β = 0.0001, 95 % CI: 0.0001-0.0001) and total time spent on ES (Time-ES: β = 0.0021, 95 % CI: 0.0014-0.0029). Each additional unit of MIMS-ES and each minute of ES daily increased CF scores by 0.0001 and 0.0021 points, respectively, suggesting benefits for cognitive health in aging populations. An inverted U-shaped relationship was observed, with inflection points at 2522.82 units/day for MIMS-ES and 91.57 min/day for Time-ES, indicating diminishing cognitive benefits beyond these thresholds.

CONCLUSION

ES was associated with higher CF. This practical form of physical activity offers an effective strategy for cognitive health and mitigating age-related decline, presenting a more accessible alternative to traditional continuous exercise.

Combined Physical-Cognitive Therapies for the Health of Older Adults with Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

Background: Mild cognitive impairment (MCI) represents an early stage of cognitive loss that significantly increases the risk of dementia. The aim of this study was to comprehensively synthesize the current evidence on the effect of combined physical and cognitive therapies in older adults with MCI. Methods: A systematic review with meta-analysis was conducted by searching for specific keywords in the PubMed, Scopus, Cinhal, and Web of Science databases. This meta-analysis included a total of 2256 participants distributed across 21 studies that evaluated the benefits of combining physical exercise with cognitive stimulation. Results: This review revealed that these types of therapies present a significant improvement in memory, attention, and executive functions. Participants showed notable improvements in these cognitive areas, highlighting the synergistic effects of physical exercise and cognitive stimulation, which exceeded the benefits of each therapy separately. These results contribute to the understanding of how these combined therapies can improve cognitive health in this population, offering robust evidence supporting their application in clinical practice. Conclusions: This meta-analysis shows that combined physical exercise and cognitive stimulation interventions may be an effective strategy for improving cognitive health in older adults with MCI. The findings of this study offer a valuable contribution to the field, highlighting the potential of these combined therapies to prevent cognitive decline and improve the quality of life of this population. The results may be of interest to health professionals and guide future research and clinical applications.

Worry Moderates Plasma Placental Growth Factor (PIGF) and Cognition in Older Adults with Amnestic Mild Cognitive Impairment (aMCI)

BACKGROUND

Elevated worry is an early indicator of cognitive decline in older adults. Worry has been linked to pro-inflammatory processes though the exact relations between worry, inflammation, and cognition in older adults with amnestic mild cognitive impairment (aMCI) remain unexplored. The present study studied the association of worry with proteomic biomarkers of inflammation and cognition.

METHOD

Participants include 66 community-dwelling older adults with amnestic mild cognitive impairment (aMCI). Inflammation was analyzed using the modified aptamer-based assay SomaScan Platform. Primary analyses consisted of two hierarchical regression models with mean-centered worry and inflammation as independent variables and age as covariate. Composite scores of executive function and processing speed were entered as the dependent variable in separate models.

RESULTS

Results indicate a significant interaction between worry and placental growth factor (PIGF) on processing speed, such that worry intensifies the inverse relationship of PIGF and processing speed. Worry did not interact with PIGF to predict executive functioning.

CONCLUSION

Findings indicate an important moderating role of worry in the association of pro-inflammatory PIGF and processing speed. Results suggest that older adults with cognitive impairment may be more susceptible to the indirect impact of worry and expands emerging research on the role of PIGF in cognitive impairment.

Searching for responders to multidomain dementia prevention in late life: A pooled analysis of individual participant data from the MAPT and preDIVA trials

INTRODUCTION

It is unknown in which, if any, subgroups of older adults multidomain interventions are effective at reducing long-term dementia incidence.

METHODS

We pooled up to 12 years of follow-up data from 5205 participants aged > 70 from the Multidomain Alzheimer Preventive Trial (MAPT) and Prevention of Dementia by Intensive Vascular Care (preDIVA) studies. The primary outcome was incident all-cause dementia. Pre-specified subgroups were defined by dementia risk factors (age, sex, education, apolipoprotein E [APOE] genotype, cognitive status, and cardiovascular risk factors).

RESULTS

Four hundred eighty-six participants developed dementia during 37,782 person-years of follow-up. Higher incidence was associated with baseline age, APOE ε4 genotype, physical inactivity, Mini-Mental State Examination, and blood pressure. Multidomain intervention had no effect on incident dementia overall (hazard ratio = 0.98, 95% confidence interval 0.80-1.21), or in any pre-specified subgroup. A recursive partitioning algorithm also did not detect any subgroups, defined by single or multiple risk factors, showing a differential intervention effect.

DISCUSSION

We did not identify any subgroups of older adults in whom multidomain interventions significantly reduced incident dementia.

CLINICAL TRIAL REGISTRATION

MAPT: NCT00672685 (clinicaltrials.gov); PreDIVA: ISRCTN29711771 (ISRCTN registry) HIGHLIGHTS: We pooled up to 12 years of follow-up data from two multidomain prevention trials. Five thousand two hundred five participants aged ≥ 70 were included. Subgroups were pre-defined by modifiable and non-modifiable dementia risk factors. A data-driven recursive partitioning algorithm was also used. Multidomain intervention did not lower incident dementia overall or in any subgroup.

Effects of multi-domain cognitive-motor training in older adults with amnestic mild cognitive impairment: A randomized controlled trial

This study aimed to examine the effect of a multi-domain cognitive-motor training program at different durations on cognitive function in older adults with amnestic mild cognitive impairment (aMCI) in China. Seventy-two older adults from a large nursing home were randomized to the multi-domain, cognitive-motor training group and usual care control group. Cognitive function included global cognition, attention, language performance, visuospatial ability, and executive function were assessed at baseline, 12 weeks, and 24 weeks. The multi-domain, cognitive-motor training program significantly improved global cognition (p < 0.05), visuospatial ability (p < 0.05), and executive function (p < 0.05) after 12- and 24- week intervention. Older adults in the training program showed significant improvements in most cognitive subdomains after 12 and 24 weeks, but not in attention and executive function after 12 weeks. The findings suggest that long-duration multi-domain cognitive-motor training positively affects cognitive function, particularly in attention and executive function in older adults with aMCI.

Acute effects of different physical activity on executive function and regulation role of beta oscillation in sedentary youth frontal region

Chronic sedentary behavior can have a negative impact on the executive function (EF) of young people. While physical activity (PA) has been shown to improve this phenomenon, the effects of different types of PA on EF vary. In this study, we compared the effects of moderate-intensity continuous training (MICT) (60-70% HRmax, 30 min), body weight training (BWT) (2 sets tabata, 20 min), and mind-body exercise (MBE) (2 sets Yang style shadowboxing, 20 min) on EF in 59 sedentary youth (n = 59, age = 20.36 ± 1.78, BMI = 24.91 ± 1.82, P>0.05) to identify the optimal dose of PA for improving EF. Metrics related to the EF task paradigm included stop signal, electroencephalogram (EEG), event-related potential (ERP), P300, N200, error-related negativity (ERN), and error positivity (Pe). error positivity (Pe), and β-wave in frontal lobe; training monitoring, including heart rate (HR), rating of perceived exertion (RPE), feeling scale (FS), and dual-mode model (DMM); load assessment, including Edward's TRIMP (TRIMP) and session-RPE (s-RPE). The study results indicate that BWT significantly improved accuracy in terms of EF (F = 16.84, P = 0.0381) and was comparable to MICT in terms of shortening reaction time (F = 58.03, P = 0.0217; F = 75.49, P = 0.0178). Regarding ERP, BWT reduced the amplitude values of N200 compared to ERN (F = 44.35, P = 0.0351; F = 48.68, P = 0.0317), increased P300 compared to Pe (F = 97.72, P<0.01; F = 29.56, P = 0.0189), and shortened P300 latency (F = 1.84, P = 0.0406). In contrast, MICT was only effective for P300 with Pe (F = 66.59, P = 0.0194; F = 21.04, P = 0.0342) and shortened N200 latency (F = 27.29, P = 0.0411). The increase in total amplitude and β-oscillation in terms of EEG was proportional to the exercise intensity, with the difference between MICT and BWT being present at 5-20 Hz, and MBE at 10-15 Hz. Regarding training load, the order of HR, RPE, TRIMP, and s-RPE was BWT > MICT > MBE (F = 202.69; F = 114.69; F = 114.69; P = 0.0342). The latency of N200 was also shortened (F = 27.29, P = 0.0411). The results showed that PA improves EF in sedentary youth, although BWT works best, it leads to a decrease in motor perception. Initially, MICT was scheduled alongside MBE and later replaced with BWT. This may help establish an exercise habit while improving EF.

The Effect of Physical Exercise on Patients With Mild Cognitive Impairment: A Scoping Review

Mild cognitive impairment (MCI) is characterized by a noticeable decline in cognitive abilities that is not severe enough to significantly interfere with daily life or independent functioning. Recent research highlights the important role of exercise in managing and improving cognitive function in patients with MCI. This scoping review examines the benefits of different forms of exercise in improving cognitive function. Recommendations for exercise, including frequency, consistency, and individualized programs, are discussed in this review, with an emphasis on the importance of safety and regular monitoring. The integration of physical and cognitive training is also suggested to maximize benefits. Regular physical exercise is a promising intervention for mitigating cognitive decline and improving the overall quality of life in patients with MCI.

Exploring the impact of adverse childhood experiences on health and cognitive functions in older adults

This study examines whether adverse childhood experiences (ACEs) predict long-term health issues and how ACEs, alongside stress, impact well-being and cognitive abilities in older adults. 279 adults were categorized into three age groups (30-46, 47-60, and 61-80). Participants completed an online survey assessing health problems, stress, resilience, and ACEs. Additionally, 32 older adults underwent cognitive tests. ACE scores predicted physical and psychological diseases in adults but not in older adults. However, a significant correlation between ACEs and cognitive abilities was evident in older participants. ACEs are significant indicators of long-term health issues and stress in adults but may not predict these factors in older individuals. Understanding ACEs' impact on cognitive abilities in older adults is crucial for tailored interventions and support.