Feasibility of a Yoga Intervention for Individuals with Mild Cognitive Impairment: A Randomized Controlled Trial

Effectiveness of Exercise Intervention on Mobility, Postural Control, and Falls for Older Adults With Mild Cognitive Impairment: A Systematic Review and Network Meta-analysis

OBJECTIVE

To review and synthesize the effectiveness of exercise interventions on mobility, postural control, and falls in older adults with mild cognitive impairment (MCI).

DATA SOURCES

This review was registered with PROSPERO (CRD42023453320) and adhered to the PRISMA guidelines. The PubMed, Embase, APA PsycInfo, Cochrane Library, Web of Science, CINAHL, and SPORTDiscus were searched from inception until September 2024.

STUDY SELECTION

Randomized controlled trials (RCTs) examining the effectiveness of exercise interventions on mobility, postural control, and falls in older adults with MCI.

DATA EXTRACTION

Data extraction included author names, publication years, participant characteristics, intervention details, outcomes, key results, and attrition rates. Data accuracy was verified by 2 reviewers, with discrepancies resolved through consultation with a third reviewer.

DATA SYNTHESIS

Thirty-two RCTs met the criteria for qualitative systematic review, with 22 RCTs included in the pairwise meta-analysis and network meta-analysis. Aerobic exercise (AE) (SMD 1.07 [95% CI, 0.62-1.52]), multicomponent exercise (SMD 0.46 [95% CI, 0.18-0.74]), and simultaneous cognitive-motor training (SMD 0.56 [95% CI, 0.23-0.89]) significantly improved gait speed during single task (P<.05). AE was the most effective intervention for single-task walking performance (99.3%), whereas Exergaming was the most effective for timed Up and Go performance (100.0%) according to the surface under the cumulative ranking. Paddling exercise (SMD 0.42 [95% CI, 0.16-0.68]) effectively increased handgrip strength (P<.05). However, network meta-analyses revealed no intervention demonstrating significant effects on postural control performance (Berg Balance Scale and Functional Reach Test scores). The effect of exercise on falls remained inconclusive because of the limited number of studies.

CONCLUSIONS

AE, multicomponent exercise, and combined cognitive-motor training significantly enhance gait speed and functional performance in older adults with MCI. However, the effect of exercise on fall risk remains unclear. These findings underscore the potential of tailored exercise interventions to improve physical function in this vulnerable population.

Impact of different exercise types on depression and anxiety in individuals with cancer: A systematic review and network meta-analysis of randomized controlled trials

OBJECTIVE

Various exercise modalities have been demonstrated to be effective in alleviating anxiety and depression among individuals with cancer. However, it remains unclear which specific exercise intervention is the optimal choice. This study aimed to systematically evaluate the impact of different exercise intervention types on anxiety and depression in individuals with cancer.

METHODS

Eligible randomized controlled trials were identified through searches of PubMed, Web of Science, and EBSCOHost, with the search period up to December 2024. Two researchers independently conducted the literature screening, data extraction, and assessment. Statistical analyses and visualizations were performed using Stata 15.0 software and RevMan5.4 software.

RESULTS

A total of 26 randomized controlled trials (involving 2118 individuals with cancer) examining three types of exercise interventions were included. Compared to usual care, mind-body exercise (SMD = -0.58, 95 % CI (-0.99, -0.17)), followed by resistance training (SMD = -0.52, 95 % CI (-1.12, 0.09)), and aerobic exercise (SMD = -0.51, 95 % CI (-0.89, -0.13)) significantly decreased depression levels among individuals with cancer. Additionally, resistance training (SMD = -0.66, 95 % CI (-1.59, 0.27)), followed by aerobic exercise (SMD = -0.59, 95 % CI (-1.08, -0.10)), and mind-body exercise (SMD = -0.48, 95 % CI (-0.96, 0.00)) significantly decreased anxiety levels among individuals with cancer compared to usual care.

CONCLUSION

The findings of this network meta-analysis suggest that mind-body exercise, resistance training, and aerobic exercise are all effective interventions for reducing anxiety and depression among individuals with cancer.

A comprehensive review on the impact of polyphenol supplementation and exercise on depression and brain function parameters

The objective of this review study is to examine the combined antidepressant effects of exercise and polyphenol supplementation, with a focus on specific polyphenolic compounds such as crocin, curcumin, and quercetin, as well as different forms of physical exercise, including aerobic and resistance training. The research examines how these interventions influence depressive-like behaviors, cognitive function, and neurochemical markers in animal models and human participants. The findings demonstrate that both exercise and polyphenols independently contribute to mood enhancement, reduced anxiety, and improved cognitive function through mechanisms such as neurogenesis, neurotransmitter modulation, and anti-inflammatory effects. Notably, the combined interventions showed a synergistic effect, providing more significant benefits in reducing symptoms of depression and anxiety, enhancing cognitive performance, and supporting overall mental well-being. These results suggest that integrating exercise and polyphenol supplementation could be a promising non-pharmacological approach to managing depression and related disorders.

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.

Exercise effects on neuropsychiatric symptoms and quality of life in mild cognitive impairment: a systematic review and meta-analysis

Background

Exercise is considered as a cost-efficient option for individuals with mild cognitive impairment (MCI). Although the potential benefits of exercise for improving cognitive function are recognized, its impact on neuropsychiatric symptoms (NPS) and the quality of life (QoL) in individuals with MCI remains unclear.

Objective

This study aims to investigate the effects of exercise interventions on NPS, including depression, anxiety, sleep disorders, and the quality of life in individuals with MCI.

Results

There were 17 randomized controlled trials (RCTs) involving 1,575 participants were included. The findings indicate a small but significant positive effect of exercise on depression (standardized mean difference [SMD] = -0.47, 95% confidence interval [CI]: -0.73 to -0.21), but the quality of the evidence is low. Mind-body exercises were relatively more effective in alleviating depression. No significant improvements were observed in sleep disorders (SMD = -1.27, 95% CI: -2.80 to 0.26). Exercise improved anxiety in one study but had no effect in the other. It also improved quality of life in seven studies, with two showing no effect.

Conclusion

The findings suggest that exercise, particularly mind-body exercises, can improve depression in individuals with MCI. However, the effect of exercise on anxiety, sleep disorders, and quality of life is still uncertain, necessitating additional research. These findings underscore the significance of integrating customized exercise programs in managing MCI to boost quality of life and mitigate NPS.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/. ID: CRD42023445369.

Comparative efficacy of various exercise interventions on depression in older adults with mild cognitive impairment: A systematic review and network meta-analysis

BACKGROUND

Exercise is a promising nonpharmacological treatment for improving depression in older adults with MCI, but it is unclear which exercises are most effective. The objectives of this study were to compare and rank the effectiveness of various exercise interventions for depression in mild cognitive impairment (MCI) and to investigate the effects of exercise on depression.

METHODS

The PRISMA-NMA guidelines were applied to the development and reporting of review criteria. The Cochrane Library, Web of Science, PsycINFO, PubMed, EMBASE, CINAHL, and Scopus databases were systematically searched by combining search terms for randomized controlled trial studies (RCTs) published in English from individual databases with the earliest available date set to March 10, 2023. Two evaluators independently selected and evaluated eligible studies of changes in depression in older adults with MCI after an exercise intervention. A protocol for this systematic review was registered in PROSPERO (Registration number: CRD42022377052).

RESULTS

A network meta-analysis was conducted on 15 eligible RCTs consisting of 4271 subjects, including aerobic (n = 6), mind-body (n = 6) and multicomponent (n = 3) exercise trials. Compared to controls, mind-body exercise showed the strongest improvement in depressive symptoms (SMD = -0.63, 95% CI: -1.13, -0.14), followed by aerobic (SMD = -0.57, 95% CI: -0.88, -0.26) and multicomponent exercise (SMD = -0.53, 95% CI: -1.02, -0.03). Notably, there were no statistically significant differences between exercise types: aerobic vs. mind-body (SMD = 0.06, 95% PrI: -0.71, 0.84), multicomponent vs. mind-body (SMD = 0.11, 95% PrI: -0.75, 0.97), or multicomponent vs. aerobic (SMD = 0.04, 95% PrI: -0.771, 0.86).

CONCLUSIONS

In this review, we found that mind-body exercise was most effective when compared to conventional controls and that multiple exercise modalities (aerobic, mind-body, and multicomponent exercise) had beneficial and comparable effects in reducing depressive states in older adults with MCI. These findings may guide clinical geriatric stakeholders and allied health professionals in providing more scientifically optimal exercise prescriptions for older adults with MCI. In the future, more high-quality, long-term clinical trials are needed to support the exploration of longer-term dynamic effects.

Diet and lifestyle impact the development and progression of Alzheimer's dementia

Dementia is a growing public health concern, with an estimated prevalence of 57 million adults worldwide. Alzheimer's disease (AD) accounts for 60-80% of the cases. Clinical trials testing potential drugs and neuroprotective agents have proven futile, and currently approved drugs only provide symptomatic benefits. Emerging epidemiological and clinical studies suggest that lifestyle changes, including diet and physical activity, offer an alternative therapeutic route for slowing and preventing cognitive decline and dementia. Age is the single most common risk factor for dementia, and it is associated with slowing cellular bioenergetics and metabolic processes. Therefore, a nutrient-rich diet is critical for optimal brain health. Furthermore, type 2 diabetes (T2D) is a risk factor for AD, and diets that reduce the risk of T2D may confer neuroprotection. Foods predominant in Mediterranean, MIND, and DASH diets, including fruits, leafy green vegetables, fish, nuts, and olive oil, may prevent or slow cognitive decline. The mechanisms by which these nutrients promote brain health, however, are not yet completely understood. Other dietary approaches and eating regimes, including ketogenic and intermittent fasting, are also emerging as beneficial for brain health. This review summarizes the pathophysiology, associated risk factors, and the potential neuroprotective pathways activated by several diets and eating regimes that have shown promising results in promoting brain health and preventing dementia.

The Impact of a Yoga-Based Mindfulness Intervention versus Psycho-Educational Session for Older Adults with Mild Cognitive Impairment: The Protocol of a Randomized Controlled Trial

BACKGROUND

There is a global agreement in the medical community that a significant proportion of dementia cases could be prevented or postponed. One of the factors behind this agreement comes from scientific evidence showing that mind-body interventions such as mindfulness and yoga for the elderly have been related to a range of positive outcomes, including improved cognition performance in seniors with mild cognitive impairment (MCI).

OBJECTIVE

This study aims to evaluate the effectiveness of a yoga-based mindfulness intervention (YBM) versus psychoeducational sessions for older adults with MCI attending Hospital Clinic Universidad de Chile in Santiago.

METHOD

Two-arm, individually randomized controlled trial (RCT) will be carried out at Clinical Hospital Universidad de Chile in Santiago. Older people over 60 years with any type of MCI using a score < 21 in the Montreal Cognitive Assessment (MoCA) test and a score of 0.05 in the Clinical Dementia Rating (CDR) Scale; and with preserved activities of daily living will be randomly assigned with an allocation ratio of 1:1 in either the yoga-based mindfulness intervention or the active control group based on the psycho-educational program. People who have performed yoga and/or mindfulness in the last 6 months or/and people with a psychiatric clinical diagnosis will be excluded from the study. Montreal Cognitive Assessment, the Lawton Instrumental Activities of Daily Living Scale (IADL), the Barthel Index (BI), the Pemberton happiness index, the Geriatric Anxiety Inventory (GAI) as well as the Geriatric Depression Scale (GDS-5) will be administered by blinded outcomes assessors before random assignment (Pre-test), the week following the last session of the intervention (post-test), and then after 3- and 6-months follow-up.

RESULTS

The YBM intervention protocol based on a video recording has been adapted and designed. This is the first RCT to examine the effects of a yoga-based mindfulness intervention in improving cognitive and physical functions and mental health outcomes for Chilean elderly diagnosed with MCI. It is expected to be implemented as an acceptable and effective non-pharmacological option for older people with MCI.

CONCLUSION

Providing evidence-based programs such as preventive therapy for Alzheimer's disease has relevant implications for public mental health services in Chile.

A Literature Review of High-Tech Physiotherapy Interventions in the Elderly with Neurological Disorders

Neurological physiotherapy adopts a problem-based approach for each patient as determined by a thorough evaluation of the patient’s physical and mental well-being. Τhis work aims to provide a literature review of physical therapy interventions in the elderly with neurological diseases (NDs) and discuss physiotherapy procedures and methods that utilize cutting-edge technologies for which clinical studies are available. Hence, the review focuses on acute NDs (stroke), deteriorating NDs (Parkinson’s disease), and age-related cognitive impairment. The most used physiotherapy procedures on which clinical data are available are balance and gait training (robot-assisted or not), occupational therapy, classical physiotherapy, walking and treadmill training, and upper limb robot-assisted therapy. Respectively, the most often-used equipment are types of treadmills, robotic-assisted equipment (Lokomat^® and Gait Trainer GT1), and portable walkway systems (GAITRite^®), along with state-of-the-art technologies of virtual reality, virtual assistants, and smartphones. The findings of this work summarize the core standard tools and procedures, but more importantly, provide a glimpse of the new era in physiotherapy with the utilization of innovative equipment tools for advanced patient monitoring and empowerment.