Aerobic exercise increases cortisol awakening response in older adults

The underlying mechanisms of family function on anxiety among nurses during the public health emergency

The occurrence of public health emergency in China often makes nurses more susceptible to anxiety. The present study aimed to investigate the prevalence of anxiety among Chinese nurses during the public health emergency and explore the association between family function and anxiety and its underlying mechanisms. Family care index questionnaire, Connor-Davidson Resilience scale, physical activity rating scale and 7-item Generalized Anxiety Disorder Scale were employed to measure family function, resilience, physical activity and anxiety among 779 Chinese nurses during public health emergency. The prevalence of anxiety among nurses during public health emergency was 29.9%. Resilience partially mediated the association of anxiety with family function. Physical activity moderated the direct and indirect effects of family function on anxiety. The direct effect became insignificant when the standard scores of physical activity were 0.629 and over. In contrast, the indirect effect of family function on anxiety through resilience was stronger when the levels of physical activity increased. The present study suggested for nurses with low levels of physical activity, intervention enhancing family function should be designed to prevent anxiety. For those with higher levels of physical activity, programs aimed at strengthening family function and supporting resilience should be developed to manage anxiety.

Comparative Efficacy of Various Interventions to Reduce Perceived Stress Among Older Adults: A Systematic Review and Network Meta-Analysis

BACKGROUND

Existing interventions targeting perceived stress in older adults exhibit a diverse range of types and inconsistent effectiveness. It remains unclear which interventions are most effective for older adults in terms of perceived stress, anxiety, depression, and cortisol levels.

AIMS

This study aimed to assess the effectiveness of interventions targeting perceived stress in older adults for perceived stress, depression, anxiety, and cortisol levels.

METHODS

A systematic search was conducted using PubMed, EMBASE, Web of Science, Cochrane, CINAHL, PsycINFO, CNKI, SinoMed, VIP, and WanFang databases on January 9, 2024 for randomized controlled trials (RCTs). Pairwise meta-analysis and network meta-analysis (NMA) were conducted using Review Manager v.5.4 and Stata v.16.0.

RESULTS

A total of 23 RCTs were included. The reminiscence therapy had the highest probability (98.6%) of being the most promising intervention to reduce perceived stress, followed by exercise (68.1%) and yoga (56.1%). The included interventions had benefits on cortisol levels (SMD = -0.30; 95% CI [-0.54, -0.06]; p = 0.01). Moreover, exercise showed positive effects on reducing depression (SMD = -1.84; 95% CI [-3.69, 0.01]; p = 0.05), and it was ranked as the most promising method for depression or anxiety. Health education also reduced anxiety symptoms compared to control group (SMD = -0.77; 95% CI [-1.27, -0.26]; p = 0.03).

LINKING EVIDENCE TO ACTION

Interventions targeting perceived stress had overall benefits in reducing perceived stress in older adults, especially reminiscence therapy and exercise. Exercise and health education each had potential benefits for alleviating depression and anxiety, respectively. More high-quality RCTs are needed to obtain more robust conclusions.

The Cortisol Awakening Response: Regulation and Functional Significance

In healthy individuals, the majority of cortisol secretion occurs within several hours surrounding morning awakening. A highly studied component of this secretory period is the cortisol awakening response (CAR), the rapid increase in cortisol levels across the first 30 to 45 minutes after morning awakening. This strong cortisol burst at the start of the active phase has been proposed to be functional in preparing the organism for the challenges of the upcoming day. Here, we review evidence on key regulatory and functional processes of the CAR and develop an integrative model of its functional role. Specifically, we propose that, in healthy individuals, the CAR is closely regulated by an intricate dual-control system, which draws upon key circadian, environmental, and neurocognitive processes to best predict the daily need for cortisol-related action. Fine-tuned CAR expression, in turn, is then assumed to induce potent glucocorticoid action via rapid nongenomic and slower genomic pathways (eg, affecting circadian clock gene expression) to support and modulate daily activity through relevant metabolic, immunological, and neurocognitive systems. We propose that this concerted action is adaptive in mediating two main functions: a primary process to mobilize resources to meet activity-related demands and a secondary process to help the organism counterregulate adverse prior-day emotional experiences.

Changes in stress pathways as a possible mechanism of aerobic exercise training on brain health: a scoping review of existing studies

Physical activity (PA) in the form of aerobic exercise (AE) preserves and improves neurocognitive function across the lifespan. However, a mechanistic understanding of the pathways by which aerobic exercise impacts brain health is still lacking, particularly with respect to stress-related pathways. One mechanistic hypothesis is that AE improves neurocognitive health in part by modifying circulating levels of stress-related hormones and signaling factors associated with the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS), as commonly measured by the biomarkers cortisol (CORT) and salivary α-amylase (sAA). Thus, this hypothesis predicts that changes in stress biomarkers, such as CORT and sAA, are possible explanatory pathways mediating the positive effects of AE on neurocognitive health. In the present review article, we provide a summary of available studies examining the possibility that exercise-induced changes to stress biomarkers could partly account for exercise-related improvements in neurocognitive health. Our review indicates that despite the intuitive appeal of this hypothesis, there is insufficient evidence available to conclude that chronic and habitual AE affects neurocognitive health by altering stress biomarker pathways. The cross-sectional nature of the majority of reviewed studies highlights the need for well-controlled studies to adequately test this hypothesis.

Neurobiological effects of exercise intervention for premenstrual syndrome

Background

Up to 75%-90% of women have varying degrees of premenstrual syndrome (PMS). Exercises are recognized to be beneficial to regulate the negative emotions associated with PMS; however, the effects of exercise on sadness inhibition have not yet been investigated from the neurobiological perspective.

Purpose

This study examined the effects of a single exercise intervention on the neural mechanisms mediating sadness response inhibition at the cortical level using multichannel event-related potential (ERP) recording in women with PMS.

Methods

Participants performed Go/No-go trials while viewing of sad or neutral images before and after exercise intervention, and changes in the No-go-evoked N200 (N2) ERP component were measured by electroencephalography (EEG) at multiple cortical sites. The associations of PMS Inventory scores with N2 amplitude and latency changes were then examined using Pearson's correlation analysis.

Results

There were no significant differences in N2 latency and response error rate following exercise compared to baseline. However, women with higher PMS Inventory scores (greater symptom severity) demonstrated significantly lengthen N2 latency at the Fz electrode sites during correct sad face No-go trials after exercise (p < 0.05), which was not the case in the pre-exercise baseline. We detected no significant relationship between the PMS score and N2 amplitude, either pre- or post-exercise.

Conclusion

Women with higher PMS severity exhibited longer sad N2 latencies as well as slow down the speed of reaction to negative stimuli by exercise, suggesting that the prefrontal emotion regulation network is involved in PMS symptoms and is sensitive to the beneficial effects of exercise.

The Structure of the Relationship between Physical Activity and Psychosocial Functioning of Women and Men during the COVID-19 Epidemic in Poland

Since the coronavirus disease (COVID-19) pandemic is a serious crisis in many countries around the world, it is important to conduct empirical research aimed at identifying risks and factors protecting the functioning of people affected by it. For this reason, the goals of the present research were to determine the level of physical activity and the severity of symptoms characteristic of mental disorders, cognitive disorders and the quality of social functioning, as well as the structure of the relationship between physical activity and psychosocial functioning of 226 women and 226 men during the COVID-19 epidemic in Eastern Poland. The research was conducted using the IPAQ-SF Questionnaire, GHQ-28 Questionnaires, TUS Test-6/9 version, the original SFS Scale and a self-developed sociodemographic survey. The collected data indicate that women as compared to men show lower levels of weekly physical activity, walking, moderate activity, vigorous activity and quality of functioning in family relationships, but higher severity of mental health disorders, somatic symptoms, functional disorders, depressive symptoms, cognitive disorders, perceptual work disorders, attention deficits and higher quality of functioning in work relationships. On the other hand, the structural model indicates that physical activity, interacting with mental health disorders and cognitive disorders, is positively associated with the social functioning of the respondents, and gender is the moderator of the occurring dependencies. This suggests that physical activity adapted to the condition of health may be an important component of gender-individualized psychopreventive interventions.

An examination of physical activity guidelines and health-related quality of life among U.S. older adults

Physical activity can help improve the poor health-related quality of life in older adult population. Although the Physical Activity Guidelines for Americans recommend both aerobic and muscle strengthening activities for adults, previous studies predominantly focused on aerobic activity with limited research on muscle strengthening activities. The purpose of this cross-sectional study was to examine the relationships between meeting physical activity guidelines (i.e., aerobic activity, muscle strengthening activity) and health-related quality of life in the older adult population. Data of 87,495 older adults aged ≥65 years from the U.S. 2019 Behavioral Risk Factor Surveillance System were analyzed. Phone interviews and validated questionnaires were used to assess aerobic activity, muscle strengthening activity, and health-related quality of life. Binomial logistic regression was used to examine the relationships between meeting physical activity guidelines and health-related quality of life while adjusting for key covariates (i.e., age, sex, race, education, marital status, employment status, income, body mass index, smoking, drinking, and comorbidities). Participants meeting both or aerobic activity guideline only had significantly lower odds of reporting all components of health-related quality of life (i.e., general health, mental health, physical health, activity limitation) than those who met neither guideline (OR = 0.37-0.58) and those who met muscle strengthening activity guideline only (OR = 0.34 - 0.74). Given the stronger positive association between aerobic activity and health-related quality of life than that between muscle strengthening activity and health-related quality of life, future research should focus on promoting aerobic activity to increase health-related quality of life among older people.

Taurine supplementation enhances endurance capacity by delaying blood glucose decline during prolonged exercise in rats

Taurine enhances physical performance; however, the underlying mechanism remains unclear. This study examined the effect of taurine on the overtime dynamics of blood glucose concentration (BGC) during endurance exercise in rats. Male F344 rats were subjected to transient treadmill exercise until exhaustion following 3 weeks of taurine supplementation or non-supplementation (TAU and CON groups). Every 10 min during exercise, BGC was measured in blood collected through cannulation of the jugular vein. Gluconeogenesis-, lipolysis-, and fatty acid oxidation-related factors in the plasma, liver, and skeletal muscles were also analyzed after 120-min run. Exercise time to exhaustion was significantly longer with taurine supplementation. BGC in the two groups significantly increased by 40 min and gradually and significantly decreased toward the respective exhaustion point. The decline in BGC from the peak at 40 min was significantly slower in the TAU group. The time when the once-increased BGC regressed to the 0-time level was significantly and positively correlated with exercise time until exhaustion. At the 120-min point, where the difference in BGC between the two groups was most significant, plasma free fatty acid concentration and acetyl-carnitine and N-acetyltaurine concentrations in skeletal muscle were significantly higher in the TAU group, whereas glycogen and glucogenic amino acid concentrations and G6Pase activity in the liver were not different between the two groups. Taurine supplementation enhances endurance capacity by delaying the decrease in BGC toward exhaustion through increases of lipolysis in adipose tissues and fatty acid oxidation in skeletal muscles during endurance exercise.

Promoting brain health through physical activity among adults exposed to early life adversity: Potential mechanisms and theoretical framework

Adverse childhood experiences such as abuse, neglect, and poverty, profoundly alter neurobehavioral development in a manner that negatively impacts health across the lifespan. Adults who have been exposed to such adversities exhibit premature and more severe age-related declines in brain health. Unfortunately, it remains unclear whether the negative effects of early life adversity (ELA) on brain health can be remediated through intervention in adulthood. Physical activity may represent a low-cost behavioral approach to address the long-term consequences of ELA on brain health. However, there has been limited research examining the impact of physical activity on brain health among adults with a history of ELA. Accordingly, the purpose of this review is to (1) review the influence of ELA on brain health in adulthood and (2) highlight evidence for the role of neurotrophic factors, hypothalamic-adrenal-pituitary axis regulation, inflammatory processes, and epigenetic modifications in mediating the effects of both ELA and physical activity on brain health outcomes in adulthood. We then propose a theoretical framework to guide future research in this area.

Cortisol reactivity to stress predicts behavioral responsivity to reward moderation by sex, depression, and anhedonia

Depression is associated with blunted reactivity to acute stress, as well as blunted responsivity to rewards. However, the extent to which responses to stress are associated with responses to reward in individuals meeting criteria for a depressive disorder is unknown. The goal of this study was to examine the relation of responses to stress and reward, and to determine if this relation is moderated by depression diagnosis, anhedonia, and sex. Participants included 114 adults (68 depressed, 46 non-depressed; 75% women) recruited from the community. Stress reactivity was operationalized as the total salivary cortisol output to the Trier Social Stress Test (TSST; Kirschbaum et al., 1993). Response bias to monetary reward was assessed following the TSST recovery period with a probabilistic reward task (PRT; Pizzagalli et al., 2005). In men only, total cortisol output during the TSST was more strongly positively associated with response bias to reward across the three blocks of the PRT. In addition, among depressed participants with high levels of anhedonia, higher cortisol output during the TSST was significantly associated with higher overall response bias to reward. We suggest that in men, the stress and reward systems may both respond quickly, and resolve rapidly, in the face of acute stress. Further, in depression, our findings suggest that anhedonia may represent a specific phenotype in which the stress and reward systems are particularly tuned together.

The impact of prior day sleep and physical activity on the cortisol awakening response

The cortisol awakening response (CAR) describes the increase in cortisol within the first 30-60 min after waking from nocturnal sleep, and is a common biomarker used within psychoneuroendocrinology, but the effect of sleep on the CAR is currently unclear. A previous study suggested that reported discrepancies may be due to other lifestyle behaviors such as physical activity; given the role of the CAR in energy regulation and preparation for the day, it is theoretically plausible that activity level would influence the CAR. However, no study has yet utilized objective monitoring of day-to-day sleep and physical activity to investigate potential effects on the CAR. This study aimed to test the hypotheses that either sleep duration or sleep quality would interact with the prior 24 h' physical activity to predict the CAR on the following morning. Salivary samples were collected from 85 young adults (mean = 19.1 years, SD = 1.89) immediately after waking from nocturnal sleep and again 30 min after waking; two complete and consecutive days were used. Participants wore accelerometers (ActiGraph, wGT3X-BT) throughout this phase of a larger study, which provided objective measures of sleep duration, number of awakenings, and amount of physical activity. Mixed-effects models with post-hoc regions of significance decompositions tested the hypothesized interaction effects. Results demonstrated a significant interaction between prior day sleep duration and physical activity predicting the next day CAR, wherein short sleep duration and high levels of physical activity resulted in an augmented CAR. Although more sleep clearly predicted a smaller next day CAR in main effect, this study provides additional support that sleep duration effects are also moderated by prior day physical activity. Both behavioral factors should be considered when assessing the CAR and the association between the CAR other psychoneuroendocrine outcomes.

Therapeutic implications of hypothalamic-pituitaryadrenal-axis modulation in Alzheimer's disease: A narrative review of pharmacological and lifestyle interventions

With disease-modifying treatments for Alzheimer's disease (AD) still elusive, the search for alternative intervention strategies has intensified. Growing evidence suggests that dysfunction in hypothalamic-pituitaryadrenal-axis (HPAA) activity may contribute to the development of AD pathology. The HPAA, may therefore offer a novel target for therapeutic action. This review summarises and critically evaluates animal and human studies investigating the effects of pharmacological and non-pharmacological intervention on HPAA modulation alongside cognitive performance. The interventions discussed include glucocorticoid receptor antagonists and 11β-hydroxysteroid dehydrogenase inhibitors as well as lifestyle treatments such as physical activity, diet, sleep and contemplative practices. Pharmacological HPAA modulators improve pathology and cognitive deficit in animal AD models, but human pharmacological trials are yet to provide definitive support for such benefits. Lifestyle interventions may offer promising strategies for HPAA modification and cognitive health, but several methodological caveats across these studies were identified. Directions for future research in AD studies are proposed.

Treatment of Aggression in Adults with Autism Spectrum Disorder: A Review

BACKGROUND

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by markedly impaired social interaction, impaired communication, and restricted/repetitive patterns of behavior, interests, and activities. In addition to challenges caused by core symptoms, maladaptive behaviors such as aggression can be associated with ASD and can further disrupt functioning and quality of life. For adults with ASD, these behaviors can portend adverse outcomes (e.g., harm to others or to the individual with ASD, hindering of employment opportunities, criminal justice system involvement). This article reviews the scientific literature to provide an update on evidence-based interventions for aggression in adults with ASD.

METHOD

A search of the electronic databases CINAHL, EMBASE, and PsycINFO was conducted using relevant search terms. After reviewing titles, abstracts, full-length articles, and reference lists, 70 articles were identified and reviewed.

RESULTS

The strongest (controlled trial) evidence suggests beneficial effects of risperidone, propranolol, fluvoxamine, vigorous aerobic exercise, and dextromethorphan/quinidine for treating aggression in adults with ASD, with lower levels of evidence supporting behavioral interventions, multisensory environments, yokukansan, and other treatments.

CONCLUSIONS

Additional randomized, controlled trials using consistent methodology that adequately addresses sources of bias are needed to determine which treatments are reliably effective in addressing aggression in adults with ASD. In the meantime, considering efficacy and adverse effect/long-term risk profiles, a practical approach could start with functional assessment-informed behavioral interventions along with encouragement of regular, vigorous aerobic exercise to target aggression in adults with ASD, with pharmacotherapy employed if these interventions are unavailable or inadequate based on symptom acuity.

Exercise-Based Interventions for Internet Addiction: Neurobiological and Neuropsychological Evidence

With the increase in the number of internet users, the problems associated with excessive internet use have become increasingly obvious. Internet addiction can alter neurobiology, and its symptoms can be alleviated through exercise, but whether exercise exerts these effects through neurobiological pathways is unclear. Here, we reviewed the neurobiological mechanisms of exercise-based interventions against internet addiction by searching PubMed and Google Scholar for relevant research using such keywords as “exercise”, “internet addiction”, “hypothalamic-pituitary-adrenal axis”, “neurotrophin”, and “dopamine”. This review summarizes advances in our understanding of the neurobiological processes through which exercise can reduce internet addiction, and our analysis strengthens the idea that exercise-based interventions can be effective in this regard. The available evidence suggests that exercise can increase the levels of neurotrophic factors, cortisol, and neurotransmitters; improve the morphology of specific parts of the central nervous system, such as by stimulating hippocampal neurogenesis; protect the autonomic nervous system; and control the reward urge. In other words, exercise appears to mitigate internet addiction by regulating the neurobiology of the central and autonomic nervous systems. In this way, exercise-based interventions can be recommended for reducing internet addiction.

The Impact of Physical Activities on Cognitive Performance among Healthy Older Individuals

The population is aging in developed countries. This aging process results in many changes, both physical and mental. Over the years, there has been a gradual decline in the level of cognitive functions closely related to the ageing process, which is most often connected with ageing diseases such as dementia. So far, pharmacological treatment has not yet been able to cure this neurological disorder. Health policies around the world seek to find alternative programs and strategies to help a healthy population prevent cognitive decline and prolong active life. One such strategy appears to be physical activity. The aim of this review is to discuss the impact of physical activity on cognitive performance among healthy older individuals. The methodology of this study is based on a systematic electronic literature search of available studies found in three databases: PubMed, Web of Science and Scopus. The findings suggest that any physical activity in older age seems to have a positive impact on the improvement of cognitive function. Furthermore, it appears that dancing, due to its multiple mechanisms, might have the biggest effect on the enhancement of cognitive performance in healthy older individuals. However, controlled clinical trials of physical activity intervention in older adults are rare. Therefore, further research in this area (particularly on the amount of physical activity, its intensity and type) is needed.

Effectiveness of stress-relieving strategies in regulating patterns of cortisol secretion and promoting brain health

Stress leads to ill-health and disease, and with today's fast-pace western society, engaging in strategies to relieve stress is crucial for good health across the life-course. Activities such as focusing on positive characteristics, art/music therapies, mindfulness, yoga and engaging with nature and/or physical activity have been shown to reduce stress and enhance well-being. It is thought that patterns of cortisol secretion, which are regulated by the brain, are a key mediator of stress-disease and well-being-health links. Measurement of cortisol in saliva is a non-invasive and ecologically valid tool for detecting early changes in brain health, as well as evaluating the effectiveness of strategies in relieving stress and improving brain health as well as monitoring stress-related brain changes. This chapter will review the evidence that engaging in stress-relieving strategies promotes regulation and/or restoration of patterns of cortisol secretion. If such strategies are found to be effective in healthy populations, they could potentially inform ways of promoting brain health and the prevention or delay of clinical disorders involving disorders in the brain (e.g., Parkinson's disease) and symptoms experienced with such disorders. To inform this field of research, recommendations are provided for the use of salivary cortisol as a marker of early monitoring of brain health and effectiveness of stress-alleviating interventions.

The effects of stress on cardiovascular disease and Alzheimer's disease: Physical exercise as a counteract measure

AD is a complicated multi-systemic neurological disorder that involves different biological pathways. Several risk factors have been identified, including chronic stress. Chronic stress produces an alteration in the activity of the hypothalamic pituitary adrenal (HPA) system, and the autonomic nervous system (ANS), which over time increase the risk of AD and also the incidence of cardiovascular disease (CVD) and risk factors, such as hypertension, obesity and type 2 diabetes, associated with cognitive impairment and AD. Considering the multi-factorial etiology of AD, understanding the complex interrelationships between different risk factors is of potential interest for designing adequate strategies for preventing, delaying the onset or slowing down the progression of this devastating disease. Thus, in this review we will explore the general mechanisms and evidence linking stress, cardiovascular disease and AD, and discuss the potential benefits of physical activity for AD by counteracting the negative effects of chronic stress, CVD and risk factors.

Effects of Different Types of Exercise Training on the Cortisol Awakening Response in Children

Context: Due to great variability of the hypothalamus-pituitary-adrenal (HPA)-axis, research has to produce better-controlled findings to make a more meaningful statement regarding the effect of exercise training (ET) on the cortisol awakening response (CAR), especially in children. Objective: The aim of the study was to investigate the effects of different ET interventions on the CAR in children. Design and setting: We conducted a short-term training study for 10 weeks in primary schools in Westphalia, Germany. Participants: 71 children (9-10 years old) were randomly assigned to a cardiovascular exercise group (n = 27), a motor exercise group (n = 23), or a control group (n = 21). Intervention: An experienced instructor trained the children in an after-school setting in 45 min sessions, three times a week over the course of 10 weeks. Main outcome measure: CAR (0, +30 min) was assessed on 2 schooldays one week apart before and after the 10-week intervention. A Shuttle Run Test was performed to determine the cardiovascular fitness. Motor fitness was assessed using the Heidelberg Gross Motor Test. Results: Children who enhanced their cardiovascular fitness over the course of the intervention showed an increased CAR after the intervention time (B = 0.213), whereas children who underwent a motor exercise intervention and at the same time gained in motor fitness exhibited a decreased CAR after intervention (B = -0.188). Conclusions: It has been speculated that other neurobiological pathways are activated by different exercise interventions. The extent to which these ET effects on CAR can be applied in clinical settings needs further investigation. Précis: The 10-weeks longitudinal effects of cardiovascular vs. motor exercise interventions (three times a week) on CAR in children show that these interventions exert different effects on hypothalamus-pituitary-adrenal (HPA) axis activity.