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Lin M, Liu W, Ma C, Gao J, Huang L, Zhu J, Liang S, He Y, Liu J, Tao J, Liu Z, Huang J, Wang Z, Chen L. Tai Chi-Induced Exosomal LRP1 is Associated With Memory Function and Hippocampus Plasticity in aMCI Patients. Am J Geriatr Psychiatry 2024; 32:1215-1230. [PMID: 38824049 DOI: 10.1016/j.jagp.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/18/2024] [Accepted: 04/19/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVES The study was designed to identify the potential peripheral processes of circulating exosome in response to Tai Chi (TC) exercise and the possibility of its loaded cargos in mediating the effects of TC training on cognitive function among older adults with amnestic mild cognitive impairment (aMCI). DESIGN, SETTING, AND PARTICIPANTS This was a multicenter randomized controlled trial. One hundred community-dwelling old adults with aMCI were randomly assigned (1:1) to experimental (n = 50) and control groups (n = 50). INTERVENTION The experimental group participated in TC exercise 5 times/week, with each session lasting 60 minutes for 12 weeks. Both experimental and control groups received health education every 4 weeks. MEASUREMENTS The primary outcome was global cognitive function. Neurocognitive assessments, MRI examination, and large-scale proteomics analysis of peripheric exosome were conducted at baseline and after 12-week training. Outcome assessors and statisticians were blinded to group allocation. RESULTS A total of 96 participants (96%) completed all outcome measurements. TC training improved global cognitive function (adjusted mean difference [MD] = 1.9, 95%CI 0.93-2.87, p <0.001) and memory (adjusted MD = 6.42, 95%CI 2.09-10.74, p = 0.004), increased right hippocampus volume (adjusted MD = 88.52, 95%CI 13.63-163.4, p = 0.021), and enhanced rest state functional connectivity (rsFC) between hippocampus and cuneus, which mediated the group effect on global cognitive function (bootstrapping CIs: [0.0208, 1.2826], [0.0689, 1.2211]) and verbal delay recall (bootstrapping CI: [0.0002, 0.6277]). Simultaneously, 24 differentially expressed exosomal proteins were detected in tandem mass tag-labelling proteomic analysis. Of which, the candidate protein low-density lipoprotein receptor-related protein 1 (LRP1) was further confirmed by parallel reaction monitoring and ELISA. Moreover, the up-regulated LRP1 was both positively associated with verbal delay recall and rsFC (left hippocampus-right cuneus). CONCLUSION TC promotes LRP1 release via exosome, which was associated with enhanced memory function and hippocampus plasticity in aMCI patients. Our findings provided an insight into potential therapeutic neurobiological targets focusing on peripheric exosome in respond to TC exercise.
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Affiliation(s)
- Miaoran Lin
- The Institute of Rehabilitation Industry (ML, WL, CM, JL, LC), Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
| | - Weilin Liu
- The Institute of Rehabilitation Industry (ML, WL, CM, JL, LC), Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
| | - Chuyi Ma
- The Institute of Rehabilitation Industry (ML, WL, CM, JL, LC), Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
| | - Jiahui Gao
- Rehabilitation Medical Technology Joint National Local Engineering Research Center (JG, LH, JZ, SL, YH, ZL), Fuzhou 350122, China
| | - Li Huang
- Rehabilitation Medical Technology Joint National Local Engineering Research Center (JG, LH, JZ, SL, YH, ZL), Fuzhou 350122, China
| | - Jingfang Zhu
- Rehabilitation Medical Technology Joint National Local Engineering Research Center (JG, LH, JZ, SL, YH, ZL), Fuzhou 350122, China
| | - Shengxiang Liang
- Rehabilitation Medical Technology Joint National Local Engineering Research Center (JG, LH, JZ, SL, YH, ZL), Fuzhou 350122, China
| | - Youze He
- Rehabilitation Medical Technology Joint National Local Engineering Research Center (JG, LH, JZ, SL, YH, ZL), Fuzhou 350122, China
| | - Jiao Liu
- The Institute of Rehabilitation Industry (ML, WL, CM, JL, LC), Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
| | - Jing Tao
- TCM Rehabilitation Research Center of SATCM (JT, JH), Fuzhou 350122, China
| | - Zhizhen Liu
- Rehabilitation Medical Technology Joint National Local Engineering Research Center (JG, LH, JZ, SL, YH, ZL), Fuzhou 350122, China
| | - Jia Huang
- TCM Rehabilitation Research Center of SATCM (JT, JH), Fuzhou 350122, China
| | - Zhifu Wang
- The Affiliated Rehabilitation Hospital (ZW), Fujian University of Traditional Chinese Medicine, Fuzhou 350003, China
| | - Lidian Chen
- The Institute of Rehabilitation Industry (ML, WL, CM, JL, LC), Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China; Fujian University of Traditional Chinese Medicine (LC), Shangjie University Town, Fuzhou, China.
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Chen W, Siew-Pin JL, Wu Y, Huang N, Teo WP. Identifying exercise and cognitive intervention parameters to optimize executive function in older adults with mild cognitive impairment and dementia: a systematic review and meta-analyses of randomized controlled trials. Eur Rev Aging Phys Act 2024; 21:22. [PMID: 39215230 PMCID: PMC11363393 DOI: 10.1186/s11556-024-00357-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024] Open
Abstract
Physical exercise is recognized for its beneficial effects on brain health and executive function, particularly through the careful manipulation of key exercise parameters, including type, intensity, and duration. The aim of this systematic review and meta-analysis was to delineate the optimal types, intensities, and durations of exercise that improve cognitive functions in older adults with mild cognitive impairment (MCI) or dementia. A comprehensive search was conducted in Scopus, Web of Science, and PubMed from their inception until December 2023. The methodological quality and publication bias of the included studies were assessed using the PEDro scale and Egger's regression test, respectively. Separate meta-analyses were performed to assess the overall impact of exercise on cognitive assessments and to explore the effects of different exercise types (i.e., aerobic, resistance, dual-task, mind-body, and multi-component exercises) and intensities (i.e., low, moderate, and high) on executive function. Results were presented as standardized mean differences (SMD) and 95% confidence intervals (95% CI). A meta-regression analysis was conducted to examine the correlation between exercise duration and mean effects. In total, 15,087 articles were retrieved from three databases, of which 35 studies were included in our final analyses. The results indicated high overall methodological quality (PEDro score = 8) but a potential for publication bias (t = 2.08, p = 0.045). Meta-analyses revealed that all types of exercise (SMD = 0.691, CI [0.498 to 0.885], p < 0.001) and intensities (SMD = 0.694, CI [0.485 to 0.903], p < 0.001) show significant effects favoring exercise. Notably, dual-task exercises (SMD = 1.136, CI [0.236 to 2.035], p < 0.001) and moderate-intensity exercises (SMD = 0.876, CI [0.533 to 1.219], p < 0.001) exhibited the greatest effect. No significant correlation was observed between exercise duration and SMD (R² = 0.038, p = 0.313). Overall, our meta-analyses support the role of physical exercise in enhancing executive function in older adults with MCI or dementia. It is essential to carefully tailor exercise parameters, particularly type and intensity, to meet the specific needs of older adults with MCI or dementia. Such customization is crucial for optimizing executive function outcomes and improving overall brain health.
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Affiliation(s)
- Wenxin Chen
- Physical Education College, Hubei University of Arts and Sciences, Hubei, China
| | - Jessie Leuk Siew-Pin
- Physical Education and Sport Science (PESS) Department, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Yuhang Wu
- School of Transportation and Logistics Engineering, Wuhan University of Technology, Wuhan, China
| | - Ning Huang
- School of Public Health, Peking University, Beijing, China
| | - Wei-Peng Teo
- Physical Education and Sport Science (PESS) Department, National Institute of Education, Nanyang Technological University, Singapore, Singapore.
- Science of Learning in Education Centre (SoLEC), National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore, 637616, Singapore.
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Guo C, Shao W, Li F, Tan X, Xie Y. Effectiveness of traditional chinese medicine (TCM) exercise therapy intervention on the cognitive function in the elderly: A systematic review and meta-analysis. Geriatr Nurs 2024; 58:352-360. [PMID: 38878735 DOI: 10.1016/j.gerinurse.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/27/2024] [Accepted: 06/03/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVES There exists a deficiency in a distinct understanding of the intervention effects of Traditional Chinese Medicine (TCM) exercise therapies (Tai Chi, Yi Jin Jing, Ba Duan Jin, Liu Zi Jue, Qigong, Wu Qin Xi etc.) on cognitive function and its moderating variables in the elderly. This study aims to systematically evaluate the effects of TCM exercise therapies on the cognitive function of the elderly and further propose the best exercise intervention programme to delay the cognitive decline of the elderly. METHODS PubMed, EBSCO host, Web of Science, EMbase, China National Knowledge Infrastructure and Wan Fang databases were searched for the effects of TCM exercise therapies on the cognitive function in older adults until July 2022. A meta-analysis of the included literature was performed using Stata 12.0 software, with a subgroup analysis of seven moderating variables: subject type, intervention content, intervention duration, intervention frequency, intervention period, study type and sample size. A random effects model was used to combine the overall effect sizes and to test for heterogeneity and publication bias across studies. RESULTS A total of 20 publications with 1975 subjects were included. The TCM exercise therapies delayed cognitive decline in older adults (d = 0.83; 95 % CI [0.62-1.04]; P < 0.001). Subgroup analysis found that intervention content, intervention duration, intervention frequency, and intervention period were significant moderating variables influencing the effectiveness of the intervention. Among them, the Ba Duan Jin intervention (d = 0.85; 95 % CI [0.65-1.06]; P < 0.001), the duration of each exercise session of 60 min or more (d = 0.86; 95 % CI [0.71-1.00]; P < 0.001), the frequency of exercise of more than 5 times per week (d = 0.80; 95 % CI [0.64-0.96]; P < 0.001) and exercise cycles of 6-9 months (d = 0.96; 95 % CI [0.80-1.12]; P < 0.001) produced the largest effect sizes. CONCLUSION TCM exercise therapies can effectively improve the cognitive function of the elderly. The best effect on the cognitive function of the elderly was achieved by choosing Ba Duan Jin and exercising at least five times a week for at least 60 min each time for a total of 6-9 months. The effect size of the TCM exercise therapy interventions on the cognitive function in older adults may be overestimated because of publication bias. In addition, large-sample, multicenter, high-quality randomised controlled trials should be conducted to validate this result.
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Affiliation(s)
- Chenggen Guo
- School of Sports Training, Wuhan Sports University, Wuhan 430079, China.
| | - Wenjuan Shao
- School of Physical Education, Minzu University of China, 100081, China
| | - Fuyou Li
- School of Physical Education and Sport, Beijing Normal University, 100875, China
| | - Xuefeng Tan
- School of Physical Education, Southwest University, Chongqing 400715, China
| | - Yongmin Xie
- School of Strength and Conditioning Training, Beijing Sport University, Beijing 100084, China
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Rampengan DDCH, Gunawan FA, Rampengan JAH, Ramadhan RN, Iqhrammullah M, Yufika A. Effectiveness of Tai Chi as a non-invasive intervention for mild cognitive impairment in the elderly: A comprehensive review and meta-analysis. NARRA J 2024; 4:e724. [PMID: 38798853 PMCID: PMC11125395 DOI: 10.52225/narra.v4i1.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024]
Abstract
The aging population warrants the increase of mild cognitive impairment (MCI) prevalence, a condition that could progress to dementia. Efforts have been made to improve the MCI and prevent its progression, including the introduction of Tai Chi, a Chinese traditional exercise. The aim of this systematic review and meta-analysis was to evaluate the efficacy of Tai Chi in attenuating MCI among the elderly population. Records investigating the effect of Tai Chi exercise intervention on cognitive function among elderly patients were searched systematically from PubMed, ScienceDirect, Google Scholar, and Europe PMC as of April 13, 2023. The risk of bias (RoB 2.0) quality assessment was employed in the quality appraisal of the studies included. Review Manager 5.4.1 was used for data extraction and meta-analysis, where the standard mean difference (SMD) and 95% confidence interval (95%CI) were computed. Eight randomized control trials with a total of 1379 participants were included in this meta-analysis. Six trials assessed Montreal Cognitive Assessment scores, where its pooled analysis suggested that Tai Chi was as effective as conventional exercise (SMD=0.15, 95%CI: -0.11 to 0.40, p=0.26). However, pooled analysis of the Mini-Mental Status Examination suggested that Tai Chi intervention more effectively improved cognitive function and reduced the rate of cognitive impairment in elderly patients (SMD=0.36, 95%CI: 0.18 to 0.54, p<0.01) as compared to the control group. This systematic review and meta-analysis suggest that, in some extent, Tai Chi is efficacious in improving cognitive function and slowing down the rate of cognitive impairment among elderly patients.
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Affiliation(s)
| | | | | | - Roy N. Ramadhan
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Muhammad Iqhrammullah
- Postgraduate Program of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia
| | - Amanda Yufika
- Department of Family Medicine, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Physical Medicine and Rehabilitation Residency Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Xu Z, Chen S, Guo M, Zhang T, Niu X, Zhou Y, Tan J, Wang J. The impact of diet quality on cognitive ability of Chinese older adults: evidence from the China Health and Nutrition Survey (CHNS). BMC Geriatr 2024; 24:55. [PMID: 38216896 PMCID: PMC10785393 DOI: 10.1186/s12877-023-04630-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 12/21/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Numerous studies have demonstrated a positive correlation between diet quality and cognitive performance, indicating that improving diet quality may be beneficial in preventing cognitive decline in older adults. However, few study has investigated the causal relationship between diet quality and cognitive performance. The purpose of this study is to evaluate the causal effects of diet quality on cognitive performance in Chinese adults aged 55 years and older. Particularly, we utilize the Chinese Diet Quality Index (CHEI), a dietary assessment tool tailored for Chinese populations, as a proxy for older adults' diet quality. METHODS Data were obtained from the China Health and Nutrition Survey (CHNS) ([Formula: see text], [Formula: see text]55 years old) conducted in 2004 and 2006. Cognitive function was tested by a subset of items from the Telephone Interview for Cognitive Status-Modified (TICS-m). Data on dietary intake was retrieved from three consecutive 24 hour recalls by participants and its quality was assessed by the 17-items Chinese Healthy Eating Index (CHEI). An Instrumental Variable technique was used to deal with the potential endogeneity of dietary quality. The instrumental variable used in our study is the community mean of CHEI. RESULTS After adjusting for socio-demographic factors (age, gender, education, per capita household income), lifestyle habits (smoking, alcohol consumption, physical activity, BMI), and chronic diseases (hypertension, diabetes), our findings revealed that improving diet quality had a significant positive effect on cognitive performance ([Formula: see text]), particularly in females aged 55-65 years ([Formula: see text]) and females with primary education and below ([Formula: see text]). CONCLUSION Our study suggests that improving diet quality and adhering to the Dietary Guidelines for Chinese may enhance cognitive performance in Chinese adults aged 55 years and older.
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Affiliation(s)
- Ziwei Xu
- Dong Fureng Institute of Economics and Social Development, Wuhan University, Bayi Road, Wuhan, 430072, Hubei, China
| | - Shuaizhen Chen
- Dong Fureng Institute of Economics and Social Development, Wuhan University, Bayi Road, Wuhan, 430072, Hubei, China
| | - Min Guo
- Dong Fureng Institute of Economics and Social Development, Wuhan University, Bayi Road, Wuhan, 430072, Hubei, China
| | - Tianlei Zhang
- Dong Fureng Institute of Economics and Social Development, Wuhan University, Bayi Road, Wuhan, 430072, Hubei, China
| | - Xiaoxuan Niu
- Dong Fureng Institute of Economics and Social Development, Wuhan University, Bayi Road, Wuhan, 430072, Hubei, China
| | - Yuxin Zhou
- Dong Fureng Institute of Economics and Social Development, Wuhan University, Bayi Road, Wuhan, 430072, Hubei, China
| | - Jialong Tan
- Dong Fureng Institute of Economics and Social Development, Wuhan University, Bayi Road, Wuhan, 430072, Hubei, China.
| | - Jian Wang
- Dong Fureng Institute of Economics and Social Development, Wuhan University, Bayi Road, Wuhan, 430072, Hubei, China.
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Hwang HF, Tseng KC, Chen SJ, Yu WY, Chen CY, Lin MR. Effects of home-based computerized cognitive training and tai chi exercise on cognitive functions in older adults with mild cognitive impairment. Aging Ment Health 2023; 27:2170-2178. [PMID: 37365961 DOI: 10.1080/13607863.2023.2225430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 06/04/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND A randomized trial was conducted to investigate the effects of computerized cognitive training (CCT) and tai chi exercise (TCE) vs. health education (HE) on cognitive functions in 189 older adults with mild cognitive impairment (MCI). METHODS Cognitive functions were assessed by the five-domain Mattis Dementia Rating Scale (MDRS) (attention, initiation/perseveration, construction, conceptualization, and memory) and the modified Telephone Interview of Cognitive Status (TICS-M), while the timed up and go (TUG), Tinetti's balance, activities of daily living (ADLs), and Activities-specific Balance Confidence (ABC) were also evaluated. Each intervention was delivered once a week for 6 months. All outcomes were followed up at 6 and 12 months of the study. RESULTS Compared to HE, CCT increased scores on the MDRS's total, initiation/perseveration, construction, and conceptualization domains and on the TICS-M at 6 months and those on the MDRS's total, attention, construction, conceptualization, and memory domains and on the TICS-M at 12 months; TCE increased scores on the MDRS's total and construction domains and on the TICS-M at 6 months and those on the MDRS's total, attention, initiation/perseveration, and conceptualization domains and on the TICS-M at 12 months. Moreover, CCT improved the TUG at 6 and 12 months and Tinetti's balance at 12 months, and TCE improved the TUG at 6 and 12 months, Tinetti's balance, and ABC at 6 and 12 months, and ADLs at 12 months. CONCLUSIONS The effects of CCT and TCE on improving global cognition and certain cognitive domains for older MCI adults may have been small but they lasted for at least 12 months.
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Affiliation(s)
- Hei-Fen Hwang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
- Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan, ROC
| | - Kuang-Chih Tseng
- Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan, ROC
| | - Sy-Jou Chen
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wen-Yu Yu
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan, ROC
| | - Chih-Yi Chen
- Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan, ROC
| | - Mau-Roung Lin
- Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan, ROC
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Park M, Song R, Ju K, Shin JC, Seo J, Fan X, Gao X, Ryu A, Li Y. Effects of Tai Chi and Qigong on cognitive and physical functions in older adults: systematic review, meta-analysis, and meta-regression of randomized clinical trials. BMC Geriatr 2023; 23:352. [PMID: 37280512 DOI: 10.1186/s12877-023-04070-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/25/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Older adults experience age-related declines in physical and cognitive functions due to interactions between aging and chronic diseases. Tai Chi and Qigong (TCQ) might be beneficial in improving the physical function and delaying the cognitive decline of this population. The potential underlying mechanism was explored to determine the effects of TCQ on cognitive function via direct or indirect pathways. PURPOSE The objective of this systematic review was to determine the effects of TCQ on cognitive and physical functions in older adults using meta-analysis, and to determine the impact of TCQ on cognitive function while controlling for physical function using a meta-regression approach. METHODS A systematic search of 13 electronic databases (in English, Korean, and Chinese languages) identified 10,292 potentially eligible studies published between inception and May 2022. The bias in individual studies was assessed using the Cochrane Risk of Bias (version 2.0) tool. The heterogeneity of the studies was evaluated using a 95% prediction interval, and the meta-analysis and meta-regression were implemented using the Comprehensive Meta-Analysis (version 3) software. RESULTS Our search identified 17 randomized studies (n = 2,365, mean age = 70.3 years). The results of the meta-analysis that used a random-effects model indicated that TCQ had significant effects on both cognitive (Hedges' g = 0.29, 95% confidence interval [CI] = 0.17 to 0.42) and physical (Hedges' g = 0.32, 95% CI = 0.19 to 0.44) functions. We used meta-regression to explore the effect size of TCQ in association with physical function level. The regression model was significant (Q = 25.01, p = .070), and 55% of the heterogeneity was explained by physical function as a moderator variable. The effects of TCQ on cognitive function remained significant in this model when controlling for the effect of physical function (β = 0.46, p = .011). CONCLUSION This meta-regression of 17 randomized studies strongly suggests that TCQ has beneficial effects on physical and cognitive functions in older adults. The effect of TCQ on cognitive function remained significant after taking into account the significant effects of physical function as a moderator. The findings imply the potential health benefits of TCQ by promoting cognitive function in older adults directly and indirectly through enhancing physical function. PROSPERO REGISTRATION NUMBER: *PROSPERO international prospective register of systematic reviews, registration ID CRD42023394358.
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Affiliation(s)
- Moonkyoung Park
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Rhayun Song
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea.
| | - Kyoungok Ju
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Jacqueline C Shin
- Indiana State University, Department of Psychology, Terre Haute, IN, 47802, USA
| | - Jisu Seo
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Xing Fan
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Xianqi Gao
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Ahyun Ryu
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
| | - Yuelin Li
- Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea
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Wang YY, Wang XX, Chen L, Liu Y, Li YR. A systematic review and network meta-analysis comparing various non-pharmacological treatments for older people with mild cognitive impairment. Asian J Psychiatr 2023; 86:103635. [PMID: 37270875 DOI: 10.1016/j.ajp.2023.103635] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/09/2023] [Accepted: 05/19/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Non-pharmacological therapy appeared to alleviate Mild Cognitive Impairment (MCI) symptoms and signs, according to systematic studies. This network meta-analysis aimed to assess the impact of non-pharmacological therapies on improving cognition in individuals with MCI and identified the most effective intervention. METHODS We reviewed six databases in search of potentially relevant studies of non-pharmacological therapies such as Physical exercise (PE), Multidisciplinary intervention (MI), Musical therapy (MT), Cognitive training (CT), Cognitive stimulation (CS), Cognitive rehabilitation (CR),Art therapy (AT), general psychotherapy or interpersonal therapy (IPT), and Traditional Chinese Medicine (TCM) (such as acupuncture therapy, massage, auricular-plaster and other related systems) and others. Excluded the literature such as missing full text, missing search results, or no reporting specific values and combined with the inclusion criteria and exclusion criteria in this article, the literature ultimately included in the analysis addressed the following seven non-drug therapies PE, MI, MT, CT, CS, CR, AT. Mini-mental state evaluation paired meta-analyses were undertaken by taking weighted average mean differences with confidence intervals (CI) of 95%. The network meta-analysis was conducted to compare various therapies. RESULTS A total of 39 randomized controlled trials, including two three-arm studies, with 3157 participants were included. PE was most likely to be the most effective intervention to slow down the cognitive ability of patients (SMD = 1.34, 95%CI: 0.80, 1.89). CS and CR had no significant effect on cognitive ability. CONCLUSIONS The non-pharmacological therapy had the potential to greatly promote the cognitive ability of the adult population with MCI. PE had the best chance of being the best non-pharmacological therapy. Due to the limited sample size, substantial variability among different study designs, and the potential for bias, the results should be regarded with caution. Our findings should be confirmed by future multi-center randomized controlled, high-quality large-scale studies.
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Affiliation(s)
- Yuan-Yuan Wang
- School of Public Health and Health Management, Anhui Medical College, Hefei City, Anhui Province 230061, China.
| | - Xiao-Xian Wang
- School of Public Health and Health Management, Anhui Medical College, Hefei City, Anhui Province 230061, China
| | - Lei Chen
- School of Public Health and Health Management, Anhui Medical College, Hefei City, Anhui Province 230061, China
| | - Yan Liu
- School of Public Health and Health Management, Anhui Medical College, Hefei City, Anhui Province 230061, China
| | - Ya-Ru Li
- School of Public Health and Health Management, Anhui Medical College, Hefei City, Anhui Province 230061, China
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Wang X, Si K, Gu W, Wang X. Mitigating effects and mechanisms of Tai Chi on mild cognitive impairment in the elderly. Front Aging Neurosci 2023; 14:1028822. [PMID: 36760710 PMCID: PMC9906996 DOI: 10.3389/fnagi.2022.1028822] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023] Open
Abstract
Mild cognitive impairment (MCI) is a major public health concern that endangers health and decreases the quality of life of the elderly around the world. A recent clinical guideline has recommended regular exercise (twice per week) for patients with MCI as part of an overall approach to management. Tai Chi, a form of light-to-moderate-intensity mind-body exercise, is particularly suitable for seniors. This review aims to summarize epidemiological studies related to the effects of Tai Chi on symptom remission in older adults with MCI and reveal the potential mechanisms. Evidence suggested that Tai Chi can improve cognitive functions and alleviate the accompanying symptoms of MCI in the elderly potentially by activating the expression of signals in different brain regions, altering their connectivity, increasing the brain volume, and modulating brain-derived neurotropic and inflammation factors. Studies comparing various types of Tai Chi may contribute to the identification of paradigms that have appropriate intensities and difficulty and exert good effects on older people with MCI. In addition, studies are warranted to determine the frequency and duration of training that can optimize the beneficial effects of Tai Chi on MCI.
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Affiliation(s)
- Xin Wang
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Keyi Si
- Department of Military Health Statistics, Naval Medical University, Shanghai, China
| | - Wei Gu
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Xueqiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
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Beversdorf DQ, Crosby HW, Shenker JI. Complementary and Alternative Medicine Approaches in Alzheimer Disease and Other Neurocognitive Disorders. MISSOURI MEDICINE 2023; 120:70-78. [PMID: 36860601 PMCID: PMC9970340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
As our population ages, there is interest in delaying or intervening in cognitive decline. While newer agents are under development, agents in mainstream use do not impact the course of diseases that cause cognitive decline. This increases interest in alternative strategies. Even as we welcome possible new disease-modifying agents, they are likely to remain costly. Herein, we review the evidence behind other complementary and alternative strategies for cognitive enhancement and prevention of cognitive decline.
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Affiliation(s)
- David Q Beversdorf
- Departments of Neurology, Radiology, and Psychological Sciences, and is the William and Nancy Thompson Endowed Chair in Radiology, , University of Missouri-Columbia School of Medicine, Columbia, Missouri
| | - Haley W Crosby
- Fourth-year medical student at the School of Medicine, , University of Missouri-Columbia School of Medicine, Columbia, Missouri
| | - Joel I Shenker
- Department of Neurology, University of Missouri-Columbia School of Medicine, Columbia, Missouri
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Wang R, Zhou H, Wang YC, Chang XL, Wang XQ. Benefits of Tai Chi Quan on neurodegenerative diseases: A systematic review. Ageing Res Rev 2022; 82:101741. [PMID: 36220604 DOI: 10.1016/j.arr.2022.101741] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 09/12/2022] [Accepted: 09/27/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Neurodegenerative diseases have become an important concern with the accelerated aging process. Tai Chi Quan (TCQ) has positive benefits for brain health and chronic diseases. The aim of this study was to summarize the protective effects of TCQ for motor function, cognition, quality of life, and mood in patients with neurodegenerative diseases. METHODS A systematic search was conducted via PubMed database and the Web of Science core collection database until August 20, 2021. The available English systematic reviews, meta-analyses, and clinical trials were included. Two reviewers completed the screening and assessment process independently. RESULTS A total of 28 studies on Parkinson's disease, 21 on cognitive impairment, and 9 on multiple sclerosis met the included criteria. The study found that TCQ remarkably improved general motor function and balance, and prevented falls for Parkinson's disease. TCQ significantly improved global cognitive function for cognitive impairment. TCQ was likely safe and beneficial for multiple sclerosis as result of heterogeneous outcomes and small samples. CONCLUSION TCQ exercise can effectively improve the motor function, global cognitive function, and falls in patients with neurodegenerative diseases. However, the positive effects of TCQ on the quality of life and mood of patients with neurodegenerative diseases need further evidence.
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Affiliation(s)
- Rui Wang
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai 200438, China
| | - Hao Zhou
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai 200438, China
| | - Yu-Chen Wang
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai 200438, China
| | - Xiao-Long Chang
- School of Physical Education and Training, Shanghai University of Sport, Shanghai 200438, China
| | - Xue-Qiang Wang
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai 200438, China; Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai 200438, China.
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Farhang M, Rojas G, Martínez P, Behrens MI, Langer ÁI, Diaz M, Miranda-Castillo C. 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. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15374. [PMID: 36430097 PMCID: PMC9690706 DOI: 10.3390/ijerph192215374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
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.
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Affiliation(s)
- Maryam Farhang
- Escuela de Enfermería, Facultad de Salud y Ciencias Sociales, Universidad de Las Américas, Santiago 8370040, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago 8380453, Chile
- Millennium Institute for Care Research (MICARE), Santiago 8370134, Chile
- Departamento de Psiquiatría y Salud Mental, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago 8380455, Chile
| | - Graciela Rojas
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago 8380453, Chile
- Departamento de Psiquiatría y Salud Mental, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago 8380455, Chile
| | - Pablo Martínez
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 150, Place Charles-Le Moyne, Longueuil, QC J4K A08, Canada
| | - Maria Isabel Behrens
- Centro de Investigación Clínica Avanzada (CICA), Hospital Clínico Universidad de Chile, Santiago 8380456, Chile
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile
- Departamento de Neurociencia, Facultad de Medicina, Universidad de Chile, Santiago 7800284, Chile
- Departamento de Neurología y Psiquiatría, Clínica Alemana Santiago, Universidad del Desarrollo, Santiago 7800284, Chile
| | - Álvaro I. Langer
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago 8380453, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago 8380455, Chile
- Mind-Body Lab, Institute of Psychological Studies, Austral University, Valdivia 5110566, Chile
| | - Marcela Diaz
- Clínica Psiquiátrica Universitaria, Hospital Clínico, Universidad de Chile, Santiago 7800284, Chile
| | - Claudia Miranda-Castillo
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago 8380453, Chile
- Millennium Institute for Care Research (MICARE), Santiago 8370134, Chile
- Faculty of Nursing, Universidad Andres Bello, Santiago 7550000, Chile
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Leung LYL, Tam HL, Ho JKM. Effectiveness of Tai Chi on older adults: A systematic review of systematic reviews with re-meta-analysis. Arch Gerontol Geriatr 2022; 103:104796. [PMID: 36058045 DOI: 10.1016/j.archger.2022.104796] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/14/2022] [Accepted: 08/24/2022] [Indexed: 11/22/2022]
Abstract
This overview study examined and synthesized the effect of Tai Chi (TC) on the physical conditions, psychological conditions, cognitive abilities, and quality of life (QoL) of older adults. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Using Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register, PubMed, Scopus, and Web of Science, English-language systematic reviews (SRs) published within the latest decade (2010-2020) were included. SRs with meta-analysis were selected if TC was the examined intervention and older adults was the targeted population. A total of 16 SRs covering 89 original studies were included. A number of the pooled results of the included SRs were inconclusive. Taking into consideration of the new meta-analyses of this study, TC significantly improved most outcomes, including the mobility, pain level, physical function, psychological distress, depressive symptoms, anxiety, global cognitive function, mental speed and attention, learning ability, verbal fluency, executive function, and QoL of older adults. TC can be an effective intervention for older adults for improving physical and psychological conditions, cognitive abilities, and QoL. Additional high-quality studies with larger samples investigating the effectiveness of TC in older adults are warranted.
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Affiliation(s)
- Leona Yuen Ling Leung
- The Ronin Institute, Montclair, NJ 07043-2314, USA; Canadian Academy of Independent Scholar, Vancouver, Canada
| | - Hon Lon Tam
- Kiang Wu Nursing College of Macau, Macau; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
| | - Jonathan Ka Ming Ho
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong
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Li F, Wang L, Qin Y, Liu G. Combined Tai Chi and cognitive interventions for older adults with or without cognitive impairment: A meta-analysis and systematic review. Complement Ther Med 2022; 67:102833. [PMID: 35439549 DOI: 10.1016/j.ctim.2022.102833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Evidence from the field of cognitive interventions indicates that nonpharmaceutical interventions seem more promising in enhancing cognition. The number of clinical trials that examine the cognitive benefits of combined physical exercise with cognitive intervention on older adults has recently increased. Tai Chi (TC) has been recommended as an effective and safe exercise for older adults aged 60 and over. However, there is a lack of conclusion about whether combined TC with cognitive interventions can show more benefits than a single intervention for older adults. Thus, this review aimed to evaluate the effects of combined TC and cognitive interventions on older adults. METHODS PubMed, Embase, PsycINFO, and Web of Science were searched for English peer-reviewed papers from inception until November 12, 2021. Data were extracted by two independent reviewers. RESULTS A total of 1524 records were generated and nine studies were included. The pooled results showed that combined TC and cognitive interventions showed significantly large gains on memory [standardised mean difference (SMD) = 0.87, 95% confidence interval (CI): (0.01, 1.74), P 0.05], moderate gains on cognition [SMD = 0.74, 95% CI:(0.19, 1.29), P 0.05], and small size effects on balance. No statistically significant difference was found in executive function, depression, risk of falls, or well-being. CONCLUSION Combined TC and cognitive interventions have positive effects on improving cognition and balance in older adults, but their superiority over the single intervention, as well as their additional effects on the physical and psychological function, are required further investigation.
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Affiliation(s)
- Fei Li
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China.
| | - Li Wang
- Nursing Department, Second Nanning People's Hospital, Nanning, Guangxi, China
| | - Yan Qin
- The First People's Hospital of Nanning, Nanning, Guangxi, China
| | - Guiying Liu
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China
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Song D, Yu D, Zhou J, Zeng L, Fan T. Effects of traditional Chinese medicine-based exercises on cognitive function in older people with mild cognitive impairment: A systematic review and meta-analysis. Geriatr Nurs 2022; 46:98-104. [PMID: 35653946 DOI: 10.1016/j.gerinurse.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/07/2022] [Accepted: 05/10/2022] [Indexed: 11/26/2022]
Abstract
This study evaluated the effects of traditional Chinese medicine based exercise (TCE) on cognitive outcomes for patients with mild cognitive impairment (MCI), and tried to identify the most effective TCE modality. A systematic review and meta-analysis of randomized controlled trials were conducted. Ten studies met the inclusion criteria. TCE interventions were classified into three types: (a) Tai Chi, (b) Baduanjin, and (c) Qigong. The pooled analysis showed that, overall, TCE had beneficial effects on global cognition and memory. Subgroup analysis further demonstrated that Baduanjin had a larger effect size on global cognition than the other TCE modalities. By contrast, Tai Chi had a larger effect size on memory than the other modalities. This study implied that TCE is a promising exercise option for improving cognition in MCI. However, further studies with a more rigorous study design are warranted to support or falsify the findings of the present review.
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Affiliation(s)
- Dan Song
- Shenzhen Qianhai Shekou Free Trade Zone Hospital, No.36, 7th Industrial Road, Nanshan District, Shenzhen City, Guangdong province, 518067, China.
| | - Doris Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William MW Mong Block, 21 Sassoon Road, Hong Kong Special Administrative Region, Pokfulam, Hong Kong, China.
| | - Jie Zhou
- Shenzhen Qianhai Shekou Free Trade Zone Hospital, No.36, 7th Industrial Road, Nanshan District, Shenzhen City, Guangdong province, 518067, China.
| | - Li Zeng
- Shenzhen Qianhai Shekou Free Trade Zone Hospital, No.36, 7th Industrial Road, Nanshan District, Shenzhen City, Guangdong province, 518067, China.
| | - Tianli Fan
- Shenzhen Qianhai Shekou Free Trade Zone Hospital, No.36, 7th Industrial Road, Nanshan District, Shenzhen City, Guangdong province, 518067, China.
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Su K, Yuan J, Liu H, Luo M, Li Q, Liu S, Feng X. The Comparative Effectiveness of Traditional Chinese Medicine Exercise Therapies in Elderly People With Mild Cognitive Impairment: A Systematic Review and Network Meta-Analysis. Front Neurol 2022; 13:775190. [PMID: 35370918 PMCID: PMC8966650 DOI: 10.3389/fneur.2022.775190] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Mild cognitive impairment (MCI) in the elderly is a health problem worldwide. Studies have confirmed that traditional Chinese medicine (TCM) exercise therapies can improve MCI. However, which therapy is the best and their impacts on brain function remain controversial and uncertain. This study aims to compare and rank TCM exercise therapies for MCI in the elderly, and analyze their effects on brain function, in order to find an optimal intervention and provide a basis for clinical treatments decision-making. Methods The Web of Science, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Clinical Trials, China National Knowledge Infrastructure (CNKI), Wangfang database, China Science and Technology Journal Database, and Chinese Biomedical Medicine (CBM) were searched through October 28, 2021. Two researchers reviewed all the studies and extracted the data. The ADDIS software version 1.16.8 and the Bayesian hierarchical model were used for pair-wise meta-analysis and network meta-analysis, and the STATA software version 14.0 was used to draw the network evidence plots and funnel plots. Results A total of 23 studies on 2282 participants were included in this study. In the pair-wise meta-analysis, TCM exercise therapies (Baduanjin exercise, Tai Chi, Liuzijue exercise and finger exercise) were superior to non-TCM exercise therapies (stretching and toning exercise, usual care, health education and routine daily activities) in terms of MMSE, MoCA and ADL outcomes. In the network meta-analysis, the MMSE outcome ranked Baduanjin exercise (78%) as the best intervention and Tai Chi (36%) as the second. The MoCA outcome ranked Baduanjin exercise (62%) as the best intervention. For the ADL outcome, Baduanjin exercise (60%) ranked the best, and followed by finger exercise (43%). Conclusion TCM exercise therapies may improve the cognitive function in elderly patients with MCI. Among the four therapies included, the Baduanjin exercise may be the preferred therapy for MCI in the elderly, and its mechanism may be related to the regulation of cognitive-related brain function and structure. Systematic Review Registration https://inplasy.com, identifier: INPLASY202070006.
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Affiliation(s)
- Kaiqi Su
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Jie Yuan
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Huanhuan Liu
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Meng Luo
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Qi Li
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Sutong Liu
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Department of Digestive Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiaodong Feng
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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Larnyo E, Dai B, Nutakor JA, Ampon-Wireko S, Larnyo A, Appiah R. Examining the impact of socioeconomic status, demographic characteristics, lifestyle and other risk factors on adults' cognitive functioning in developing countries: an analysis of five selected WHO SAGE Wave 1 Countries. Int J Equity Health 2022; 21:31. [PMID: 35216605 PMCID: PMC8876754 DOI: 10.1186/s12939-022-01622-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 01/24/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Though extensive studies have been conducted on assessing the predictors of cognitive functioning among older adults in small community-based samples, very few studies have focused on understanding the impact of socioeconomic status (SES), demographic characteristics and other risk factors such as lifestyle and chronic diseases on the cognitive functioning among adults of all ages in a nationally representative population-based sample across low- and middle-income countries. This study, therefore, seeks to evaluate the impact of SES, demographic characteristics and risk factors on the cognitive functioning of adults across all ages in five selected developing countries. METHODS Data from 12,430 observations obtained from the WHO Study on Global AGEing and Adult Health (SAGE) Wave 1; consisting of 2,486 observations each for China, Ghana, India, the Russian Federation, and South Africa, were used for the study. A meta-regression and a five-step hierarchical linear regression were used to analyze the data, with cognitive functioning as the dependent variable. Independent variables used in this study include SES; assessed by household income and education, demographic characteristics, other risk factors such as lifestyle, self-reported memory difficulty and chronic diseases. RESULTS This study found that SES and lifestyle significantly predicted cognitive functioning in all the five selected countries as obtained by the pooled results of the meta-regression analysis. The hierarchical linear regression results also revealed that demographic characteristics such as age, type of residency, and self-reported memory difficulty significantly impact cognitive functioning in China, Ghana, Russia, and South Africa. CONCLUSION The findings in this study provide new insights for policymakers, caregivers, parents, and individuals, especially those in developing countries, to implement policies and actions targeted at improving SES and eliminating risk factors associated with cognitive decline, as these measures could help improve the cognitive functioning among their populations.
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Affiliation(s)
- Ebenezer Larnyo
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
| | - Baozhen Dai
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China.
- Department of Labor and Social Security, School of Public Health, Southeast University, 87# Dingjiaqiao, Nanjing, 210009, Jiangsu province, China.
| | - Jonathan Aseye Nutakor
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
| | - Sabina Ampon-Wireko
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
| | - Abigail Larnyo
- School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
| | - Ruth Appiah
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
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Ukawa S, Tamakoshi A, Tani Y, Sasaki Y, Saito J, Haseda M, Shirai K, Kondo N, Kondo K, Kawachi I. Leisure activities and instrumental activities of daily living: A 3-year cohort study from the Japan Gerontological Evaluation Study. Geriatr Gerontol Int 2021; 22:152-159. [PMID: 34936183 DOI: 10.1111/ggi.14334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 11/02/2021] [Accepted: 12/05/2021] [Indexed: 11/28/2022]
Abstract
AIM We prospectively examined the association between leisure activities and changes in instrumental activities of daily living (IADL) among participants of the Japan Gerontological Evaluation Study (JAGES). METHODS We analyzed data collected from 49 732 JAGES participants (23 359 men and 26 373 women), aged ≥65 years, from 24 municipalities in Japan. MEASUREMENTS Baseline data were obtained for 25 types of leisure activities in which the cohort members participated. Baseline (2010) and follow-up (2013) data on IADL were collected - the outcome indicated changes in IADL scores from 2010 to 2013. We regressed changes in IADL scores from the 2010 to 2013 to the number of leisure activities. RESULTS Older adults who engaged in more leisure activities had higher changes in IADL scores than those who engaged in fewer leisure activities: the β values (95% confidence interval [CI]) of the IADL scores were 0.001 [-0.04-0.04], 0.04 [0.01-0.08], 0.09 [0.05-0.13], 0.09 [0.05-0.14], 0.08 [0.02-0.13], and 0.13 [0.07-0.18] for having one, two, three, four, five, and more than six types of leisure activities (P for trend <0.001), respectively. Similar associations were found for different types of leisure activities, including predominantly physical and cultural activities. Statistically significant linear trends were obtained among the group, solitary, and other leisure activity subgroups (P for trend <0.05). CONCLUSIONS Encouraging engagement in leisure activities may promote maintenance of IADL among older populations. Different types of leisure activities appear to have similar positive impacts on IADL. Geriatr Gerontol Int 2021; ••: ••-••.
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Affiliation(s)
- Shigekazu Ukawa
- Osaka City University Graduate School of Human Life Science, Osaka, Japan.,Department of Public Health, Faculty and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Faculty and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuri Sasaki
- Department of International Health and Collaboration, National Institute of Public Health, Saitama, Japan
| | - Junko Saito
- Behavioral Science Division, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Maho Haseda
- Department of Social Epidemiology, School of Public Health, Kyoto University, Kyoto, Japan
| | - Kokoro Shirai
- Department of Public Health, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, School of Public Health, Kyoto University, Kyoto, Japan.,Japan Agency for Gerontological Evaluation Study, Tokyo, Japan.,Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Katsunori Kondo
- Japan Agency for Gerontological Evaluation Study, Tokyo, Japan.,Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Effect of Tai Chi on Cognitive Function among Older Adults with Cognitive Impairment: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6679153. [PMID: 34394392 PMCID: PMC8360724 DOI: 10.1155/2021/6679153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 02/03/2023]
Abstract
Background Cognitive decline occurs in all persons during the aging process and drugs can only alleviate symptoms and are expensive. Some researches demonstrated that Tai Chi had potential in preventing cognitive decline while others' results showed Tai Chi had no influence on cognitive impairment. Therefore, we conduct a systematic review and meta-analysis to assess the efficacy and safety of cognitive impairment patients practicing Tai Chi. Methods A comprehensive literature search was carried out in multiple databases, including PubMed, Cochrane, MEDLINE (Ovid), Web of Science, Embase, Scopus, PsycInfo (Ovid), CKNI, Wan Fang, VIP, SinoMed, and ClinicalTrails, from their inception to 1 July 2020 to collect randomized controlled trials about practicing Tai Chi for patients with cognitive impairment. Primary outcomes included changes of cognitive function and secondary outcomes included changes of memory functions. Data were extracted by two independent individuals and Cochrane Risk of Bias tool version 2.0 was applied for the included studies. Systematic review and meta-analysis were performed by RevMan 5.3 software. Results The results included 827 cases in 9 studies, of which 375 were in the experimental group and 452 were in the control group. Meta-analysis showed that Mini-Mental State Examination WMD = 1.52, 95% CI [0.90, 2.14]; Montreal Cognitive Assessment WMD = 3.5, 95% CI [0.76, 6.24]; Clinical Dementia Rating WMD = −0.55, 95% CI [−0.80, −0.29]; logical memory delayed recall WMD = 1.1, 95% CI [0.04, 2.16]; digit span forward WMD = 0.53, 95% CI [−0.65, 1.71]; and digit span backward WMD = −0.1, 95% CI [−0.38, 0.19]. No adverse events were reported in the included articles. Conclusion There is limited evidence to support that practicing Tai Chi is effective for older adults with cognitive impairment. Tai Chi seems to be a safe exercise, which can bring better changes in cognitive function score.
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Siu MY, Lee DTF. Is Tai Chi an effective intervention for enhancing health-related quality of life in older people with mild cognitive impairment? An interventional study. Int J Older People Nurs 2021; 16:e12400. [PMID: 34254731 DOI: 10.1111/opn.12400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 05/24/2021] [Accepted: 06/01/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Many neuropsychiatric symptoms in persons of MCI cause negative impacts on their HRQOL. There is limited HRQOL research investigating the effect of Tai Chi on older people with MCI. OBJECTIVE To determine the effectiveness of a Tai Chi program in enhancing health-related quality of life (HRQOL) among community-dwelling older people with mild cognitive impairment (MCI) in Hong Kong. METHODS This was a quasi-experimental study using a nonequivalent control group (CG) design. Four social centres for older people participated in the study, of which two centres were randomised for Tai Chi intervention and the other two were treated as control. Participants in the intervention group (IG) were arranged for a 1-hour Tai Chi class twice weekly for 16 weeks, whereas participants in the CG were advised to join various recreational activities in the social centres as usual. For outcome evaluation, the Chinese version of the Short Form-12 Health Survey-Standard 1 (SF-12) was employed to assess participants' perceived HRQOL. RESULTS One hundred and sixty participants were recruited (IG = 80, CG = 80). Data were collected at baseline (T0) and 16-week post-intervention (T1).The IG reported significant improvement in the physical health component (PCS) (p = .036), the mental health component (MCS) (p = .014), as well as several subscales of SF-12, namely, the role-physical (RP) (p = .044), the bodily pain (BP) (p < .001) and the vitality (VT) (p = .004) subscales, in comparison with the CG. CONCLUSION The current study results extended our knowledge about Tai Chi of which the mind-body exercise could enhance the physical and psychosocial well-being in older people with MCI. IMPLICATIONS FOR PRACTICE The findings have the potential to inform health and social care professionals to promote Tai Chi in community settings, as it may represent a non-intensive and age-fitting strategy to promote HRQOL in older people with MCI. TRIAL REGISTRATION NCT03404765 (Retrospectively registered January 19, 2018).
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Affiliation(s)
- Mei-Yi Siu
- School of Nursing, Union Hospital, Hong Kong SAR, China
| | - Diana T F Lee
- The Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong SAR, China
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21
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Heinrich KM, Crawford DA, Langford CR, Kehler A, Andrews V. High-Intensity Functional Training Shows Promise for Improving Physical Functioning and Activity in Community-Dwelling Older Adults: A Pilot Study. J Geriatr Phys Ther 2021; 44:9-17. [PMID: 31626033 DOI: 10.1519/jpt.0000000000000251] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Healthy aging allows older adults to remain active in their communities; however, sedentary behaviors can lead to physical deconditioning and decreased physical function. Structured exercise programs are recommended to facilitate activity engagement and prevent muscle atrophy due to aging to facilitate older adults' abilities to complete activities of daily living. In particular, high-intensity functional training (HIFT) is a multicomponent group exercise program that has previously been shown to increase physical function for middle-age cancer survivors. This study examined the preliminary feasibility and effectiveness of HIFT for improving physical function and participation in physical activity for community-dwelling older adults. METHODS The 8-week pilot study included two 60-minute HIFT sessions per week. Participants (n = 8) were 75% female with a mean age of 71 (6) years. Study initiation, adherence, and acceptability were assessed to determine feasibility. Effectiveness was assessed via 5 physical function measures conducted during sessions 1 and 16 and included the Timed Up and Go, lift and carry test, chair stand test, a repeated stair climb test, and the 6-minute walk test. Participants also self-reported confidence and difficulty for activities of daily living via the Outpatient Physical Therapy Improvement in Movement Assessment Log and physical activity participation via the Community Health Activities Model Program for Seniors questionnaire. RESULTS AND DISCUSSION The study recruitment rate was 88.9% and 87.5% of participants adhered. Intervention acceptability was promising, as 4 participants reported liking multiple aspects of the intervention (eg, coaching/supervision and similar age peers). Intervention effectiveness was promising with significant improvement in 1 of 5 physical function measures, although clinical effects were most likely trivial. Participants reported increased participation in both leisure and structured physical activities. CONCLUSIONS HIFT appeared feasible and showed promise for counteracting the loss of physical function and sedentary behaviors associated with aging. Results should be confirmed in a longer, fully powered study.
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Affiliation(s)
- Katie M Heinrich
- Functional Intensity Training Laboratory, Department of Kinesiology, Kansas State University, Manhattan
| | - Derek A Crawford
- School of Nutrition, Kinesiology, and Psychological Science, University of Central Missouri, Warrensburg
| | - Cheyenne R Langford
- Functional Intensity Training Laboratory, Department of Kinesiology, Kansas State University, Manhattan
| | - Ainslie Kehler
- Functional Intensity Training Laboratory, Department of Kinesiology, Kansas State University, Manhattan
| | - Victor Andrews
- Functional Intensity Training Laboratory, Department of Kinesiology, Kansas State University, Manhattan
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Birimoglu Okuyan C, Deveci E. The effectiveness of Tai Chi Chuan on fear of movement, prevention of falls, physical activity, and cognitive status in older adults with mild cognitive impairment: A randomized controlled trial. Perspect Psychiatr Care 2021; 57:1273-1281. [PMID: 33184928 DOI: 10.1111/ppc.12684] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/22/2020] [Accepted: 10/31/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE This study aimed to investigate the effectiveness of Tai Chi Chuan (TCC) on fear of movement, prevention of falls, physical activity, and cognitive status in older adults with mild cognitive impairment. DESIGN AND METHODS This controlled trial was conducted with 20 participants in the intervention group, and they did exercises for 35-40 min/session, twice a week for 12 weeks. FINDING The posttest scores of the scales indicated that the scores of cognitive adaptations, being observant, and changes in level subscales of the fall behavioral scale in the older adults who did Tai Chi exercise in the intervention group significantly increased (p < .01). PRACTICE IMPLICATIONS The nursing home provider can safely manage TCC exercise interventions for older adults with MCI.
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Affiliation(s)
- Canan Birimoglu Okuyan
- Department of Public Health Nursing, Faculty of Health Sciences, Sakarya University of Applied Sciences, Sakarya, Turkey
| | - Ebru Deveci
- Department of Anesthesia, Vocational School of Health Services, University of Hasan Kalyoncu, Gaziantep, Turkey
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23
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Engel-Yeger B, Rosenblum S. Executive dysfunctions mediate between altered sensory processing and daily activity performance in older adults. BMC Geriatr 2021; 21:132. [PMID: 33618664 PMCID: PMC7898742 DOI: 10.1186/s12877-021-02032-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/18/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Sensory processing is essential for the interaction with the environment and for adequate daily function. Sensory processing may deteriorate with aging and restrict daily activity performance. Aging may also affect Executive functions (EFs) which are critical for daily activity performance. Yet, most studies refer separately to the impacts of sensory processing or EFs and use clinical evaluations that do not necessarily reflect functional restrictions in real life. This study aims to describe the prevalence of altered sensory processing in the elderly as expressed in daily life scenarios and explore whether EFs mediate between altered sensory processing and daily activity performance in older adults. METHODS This cross-sectional study included 167 healthy independently functioning people aged 65 and above who were living in the community, had sufficient cognitive status and no symptoms of depression (based on the GDS and the MMSE). All participants completed a socio-demographic-health questionnaire, the Adolescent/Adult Sensory Profile, the Behavior Rating Inventory of Executive Function-Adult Version and the Daily Living Questionnaire. RESULTS Altered sensory processing, and mainly by the reduced ability to register and modulate sensory input from daily environment, were prevalent in older adults. Their impacts on daily activity performance were mediated by executive dysfunctions. CONCLUSIONS Executive dysfunctions may worsen the negative effects of altered sensory processing on daily activity performance in older adults. The interaction between EFs and sensory processing should receive growing attention in intervention and prevention programs for older adults, with the emphasis on their expressions and implications on peoples' function in real life context.
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Affiliation(s)
- Batya Engel-Yeger
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Aba Hushi, 199, Mount Carmel, 3498838, Haifa, Israel.
| | - Sara Rosenblum
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Aba Hushi, 199, Mount Carmel, 3498838, Haifa, Israel
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24
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Li C, Zheng D, Luo J. Effects of traditional Chinese exercise on patients with cognitive impairment: A systematic review and Bayesian network meta-analysis. Nurs Open 2021; 8:2208-2220. [PMID: 33605528 PMCID: PMC8363389 DOI: 10.1002/nop2.799] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 11/16/2020] [Accepted: 01/29/2021] [Indexed: 12/12/2022] Open
Abstract
Objective To systematically review the effectiveness of four types of traditional Chinese exercise (TCE) on patients with cognitive impairment (CI) and to rank these four TCE types. Design A Bayesian network meta‐analysis. Methods Four English databases, including PubMed, EMBASE, Cochrane Library and Web of Science, and three Chinese databases, including CNKI, VIP and Wanfang, were searched from their inception to December 2019. Randomized control trials conducted to verify the effects of TCE on patients with CI were included. We used network meta‐analysis to evaluate the relative effects and rank probabilities of the four types of TCE. Results The results of the network meta‐analysis indicated that baduanjin (N = 9), tai chi (N = 11), liuzijue (N = 2) and qigong (N = 1) all had significant benefits compared with control conditions. According to the ranking probabilities, baduanjin was most likely to be associated with substantial improvement in cognition, followed by tai chi, liuzijue and qigong. Conclusion Our study revealed the effectiveness of TCE for improving global cognition in adults with cognitive impairment. Baduanjin may be the most effective exercise type. The evidence summarized in our study still contains bias, and more research should be carried out to verify the validity of TCE.
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Affiliation(s)
- Chen Li
- Neurology Department, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Dongxiang Zheng
- Neurology Department, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jinglan Luo
- Internal Medicine Department, The First Affiliated Hospital of Jinan University, Guangzhou, China
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25
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Cai Z, Jiang W, Yin J, Chen Z, Wang J, Wang X. Effects of Tai Chi Chuan on Cognitive Function in Older Adults with Cognitive Impairment: A Systematic and Meta-Analytic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2020; 2020:6683302. [PMID: 33424991 PMCID: PMC7781704 DOI: 10.1155/2020/6683302] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/03/2020] [Accepted: 12/18/2020] [Indexed: 11/18/2022]
Abstract
This systematic and meta-analytic review aimed to investigate the effects of Tai Chi Chuan (TCC) on the cognitive function of the elderly with cognitive impairment and to analyze the moderators of these effects. We searched eight electronic databases for randomized controlled trials on the effects of TCC on cognitive function, published up to June 14, 2020. The PEDro scale was used to evaluate the methodological quality of the included literature. Stata14.0 software was used for meta-analysis, subgroup analysis, and publication bias testing. A total of 19 studies and 1,970 samples were included. The methodological quality of the included literature was fair to good, and there was no publication bias. Overall, the research shows that the effect of TCC on the elderly with cognitive impairment is statistically significant (SMD = 0.31, p < 0.0001). Five of the cognitive function subdomains were significant moderators [Q (5) = 15.66, p=0.008], and the effect size (ES) was the largest for global cognitive function (SMD = 0.41), followed by executive function (SMD = 0.33), memory (SMD = 0.31), and verbal fluency (SMD = 0.27). Regarding the exercise prescription variables, results were significantly moderated by the length of exercise training [Q (2) = 6.00, p=0.05], with ESs largest for moderate length (SMD = 0.41), followed by short length (SMD = 0.40) and long length (SMD = 0.29). However, the results were not moderated by session time or frequency. TCC can improve multiple cognitive functions of the elderly with cognitive impairment. The intervention effects are moderated by exercise length, but not by exercise session time and frequency.
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Affiliation(s)
- Zhidong Cai
- School of Physical Education and Training, Shanghai University of Sport, Shanghai 200438, China
| | - Wanting Jiang
- School of Physical Education and Training, Shanghai University of Sport, Shanghai 200438, China
| | - Jilin Yin
- Physical Education Department, Beibu Gulf University, Qinzhou 535011, China
| | - Zhitong Chen
- School of Physical Education and Health, Shanghai Lixin University of Accounting and Finance, Shanghai 201620, China
| | - Jing Wang
- School of Physical Education and Health, Shanghai Lixin University of Accounting and Finance, Shanghai 201620, China
| | - Xing Wang
- School of Physical Education and Training, Shanghai University of Sport, Shanghai 200438, China
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26
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Wei L, Chai Q, Chen J, Wang Q, Bao Y, Xu W, Ma E. The impact of Tai Chi on cognitive rehabilitation of elder adults with mild cognitive impairment: a systematic review and meta-analysis. Disabil Rehabil 2020; 44:2197-2206. [PMID: 33043709 DOI: 10.1080/09638288.2020.1830311] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Li Wei
- Tianjin Medical University General Hospital, Tianjin, China
| | - Qianwen Chai
- Tianjin Medical University General Hospital Airport Site, Tianjin, China
| | - Jin Chen
- Tianjin Medical University General Hospital, Tianjin, China
| | - Qin Wang
- Tianjin Medical University General Hospital, Tianjin, China
| | - Yuting Bao
- Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Weiwei Xu
- Tianjin Medical University General Hospital, Tianjin, China
| | - Enting Ma
- Tianjin Medical University General Hospital, Tianjin, China
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27
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Wang YQ, Jia RX, Liang JH, Li J, Qian S, Li JY, Xu Y. Effects of non-pharmacological therapies for people with mild cognitive impairment. A Bayesian network meta-analysis. Int J Geriatr Psychiatry 2020; 35:591-600. [PMID: 32119152 DOI: 10.1002/gps.5289] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/21/2020] [Accepted: 02/25/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To compare the effects of non-pharmacological therapies (NPTs) on improving the cognition of people with mild cognitive impairment (MCI) by performing a Bayesian network meta-analysis (NMA). METHODS We searched eight databases for potentially eligible studies. Physical exercise (PE), cognitive stimulation (CS), cognitive training (CT), cognitive rehabilitation (CR), musical therapy (MT) and multi-domain interventions (MI). Pairwise meta-analyses were performed by estimating the weighted mean differences with 95% confidence interval (CI) for mini-mental state examination. The NMA was undertaken to compare different interventions. RESULTS CS, PE, MI, MT and CT may all be effective in improving the cognition of patients with MCI. CR was unable to show a significant efficacy. Our NMA ranking results suggest the effectiveness of the six NPTs to be ranked from best to worst as follows: CS, PE, MI, MT, CT and CR. CONCLUSIONS NPT has great potential to improve the cognition of the elderly with MCI. CS has the highest probability of being the optimal NPT. However, the result should be interpreted with cautions given the limited number and small samples of included randomized controlled trials (RCTs) in this field, large diversity existing in different study designs and potential risk of bias. Future RCTs with high quality and large sample sizes are required to confirm our results. SUMMARY NPT, as a whole definition, has great potential to improve the cognition of the elderly with MCI. Our NMA ranking results suggest the effectiveness of the six NPTs to be ranked from best to worst as follows: CS, PE, MI, MT, CT and CR.
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Affiliation(s)
- Ying-Quan Wang
- Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Rui-Xia Jia
- Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Jing-Hong Liang
- Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Jing Li
- Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Sheng Qian
- Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Jia-Yu Li
- Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Yong Xu
- Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
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28
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Ding G, Zhao X, Wang Y, Song D, Chen D, Deng Y, Xing W, Dong H, Zhou Y, Li D, Hou H. Evaluation of the relationship between cognitive impairment and suboptimal health status in a northern Chinese population: a cross-sectional study. J Glob Health 2020; 10:010804. [PMID: 32257168 PMCID: PMC7101211 DOI: 10.7189/jogh.10.010804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Suboptimal health status (SHS) is an intermediate health status between ideal health and illness. As a determinant of cardiovascular disease and stroke, SHS is hypothesized to be associated with the development of cognitive impairment and dementia. This study aimed to investigate whether individuals with SHS have poor cognitive ability based on a community-based cohort in northern Chinese population. Methods 3524 participants who were enrolled in Jidong cohort 2015 in Tangshan City were investigated in this study. Cognitive function was measured with the Mini-Mental State Examination (MMSE). SHS level was evaluated using a self-reporting Suboptimal Health Status Questionnaire-25 (SHSQ-25). The relationship between SHS and cognitive function was analyzed with logistic regression analysis, by which odds ratio (OR) and 95% confidence interval (CI) were calculated. Results The prevalence of cognitive impairment was 3.4% (121/3524) in our study, with the prevalence rates of 1.9% (34/1750) among men and 4.9% (87/1774) in women. The medians of total score of MMSE were 28 (interquartile range (IQR) = 27-29) in the SHS group, and 29 (IQR = 27-30) in the ideal health group. Logistic regression analysis showed that SHS was significantly correlated with cognitive impairment (adjusted OR = 2.936, 95% CI = 1.428-6.033). With regard to gender, the OR was 5.067 (95% CI = 1.346-19.068) in men, which was higher than that in women (OR = 2.324, 95% CI = 1.130-4.779). Conclusions SHS might be a risk factor for cognitive function in northern Chinese population. Early screening of SHS individuals, as well as urgent treatment of SHS might contribute to the prevention of cognitive impairment.
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Affiliation(s)
- Guoyong Ding
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China.,Equal authorship
| | - Xuan Zhao
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China.,Equal authorship
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.,Equal authorship
| | - Daiyu Song
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
| | - Dongzhen Chen
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
| | - Yang Deng
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
| | - Weijia Xing
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
| | - Hualei Dong
- Taishan Hospital of Shandong Province, Taian, Shandong Province, China
| | - Yong Zhou
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Dong Li
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
| | - Haifeng Hou
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
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Patnode CD, Perdue LA, Rossom RC, Rushkin MC, Redmond N, Thomas RG, Lin JS. Screening for Cognitive Impairment in Older Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2020; 323:764-785. [PMID: 32096857 DOI: 10.1001/jama.2019.22258] [Citation(s) in RCA: 138] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Early identification of cognitive impairment may improve patient and caregiver health outcomes. OBJECTIVE To systematically review the test accuracy of cognitive screening instruments and benefits and harms of interventions to treat cognitive impairment in older adults (≥65 years) to inform the US Preventive Services Task Force. DATA SOURCES MEDLINE, PubMed, PsycINFO, and Cochrane Central Register of Controlled Trials through January 2019, with literature surveillance through November 22, 2019. STUDY SELECTION Fair- to good-quality English-language studies of cognitive impairment screening instruments, and pharmacologic and nonpharmacologic treatments aimed at persons with mild cognitive impairment (MCI), mild to moderate dementia, or their caregivers. DATA EXTRACTION AND SYNTHESIS Independent critical appraisal and data abstraction; random-effects meta-analyses and qualitative synthesis. MAIN OUTCOMES AND MEASURES Sensitivity, specificity; patient, caregiver, and clinician decision-making; patient function, quality of life, and neuropsychiatric symptoms; caregiver burden and well-being. RESULTS The review included 287 studies with more than 280 000 older adults. One randomized clinical trial (RCT) (n = 4005) examined the direct effect of screening for cognitive impairment on patient outcomes, including potential harms, finding no significant differences in health-related quality of life at 12 months (effect size, 0.009 [95% CI, -0.063 to 0.080]). Fifty-nine studies (n = 38 531) addressed the accuracy of 49 screening instruments to detect cognitive impairment. The Mini-Mental State Examination was the most-studied instrument, with a pooled sensitivity of 0.89 (95% CI, 0.85 to 0.92) and specificity of 0.89 (95% CI, 0.85 to 0.93) to detect dementia using a cutoff of 23 or less or 24 or less (15 studies, n = 12 796). Two hundred twenty-four RCTs and 3 observational studies including more than 240 000 patients or caregivers addressed the treatment of MCI or mild to moderate dementia. None of the treatment trials were linked with a screening program; in all cases, participants were persons with known cognitive impairment. Medications approved to treat Alzheimer disease (donepezil, galantamine, rivastigmine, and memantine) improved scores on the ADAS-Cog 11 by 1 to 2.5 points over 3 months to 3 years. Psychoeducation interventions for caregivers resulted in a small benefit for caregiver burden (standardized mean difference, -0.24 [95% CI, -0.36 to -0.13) over 3 to 12 months. Intervention benefits were small and of uncertain clinical importance. CONCLUSIONS AND RELEVANCE Screening instruments can adequately detect cognitive impairment. There is no empirical evidence, however, that screening for cognitive impairment improves patient or caregiver outcomes or causes harm. It remains unclear whether interventions for patients or caregivers provide clinically important benefits for older adults with earlier detected cognitive impairment or their caregivers.
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Affiliation(s)
- Carrie D Patnode
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Leslie A Perdue
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | | | - Megan C Rushkin
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Nadia Redmond
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Rachel G Thomas
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Jennifer S Lin
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
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O'Neill D, Forman DE. The importance of physical function as a clinical outcome: Assessment and enhancement. Clin Cardiol 2020; 43:108-117. [PMID: 31825137 PMCID: PMC7021659 DOI: 10.1002/clc.23311] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 11/20/2019] [Indexed: 02/06/2023] Open
Abstract
The burgeoning population of older adults is intrinsically prone to cardiovascular disease (CVD) in a context of multimorbidity and geriatric syndromes. Risks include high susceptibility to functional decline, with many older adults tipping towards patterns of sedentary behavior and to downstream effects of frailty, falls, disability, poor quality of life, as well as increased morbidity and mortality even if the incident CVD was treated perfectly. While physical activity has been shown to moderate these patterns both as primary or secondary preventive medical care, the majority of older adults fail to meet physical activity recommendations. Clinicians of all specialities, including CVD medicine, can benefit from greater proficiency in functional assessments for their older adults, as well as from insights how to initiate effective functional enhancing approaches even in older adults who may be frail, deconditioned, and medically complex. Pertinent functional assessments include traditional cardiovascular metrics of cardiorespiratory fitness, as well as strength and balance. This review summarizes the components of a wide-ranging functional assessment that can be used to enhance care for older adults with CVD, as well as interventions to improve physical function.
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Affiliation(s)
| | - Daniel E. Forman
- Professor of MedicineUniversity of Pittsburgh University of Pittsburgh Medical Center and VA Pittsburgh Healthcare SystemPittsburghPennsylvania
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31
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Wang J, Zhu WH, Li YF, Zhu WW. Temporal precedence of cognitive function and functional abilities: A latent difference score model of the Chinese community-dwelling elders. Int J Geriatr Psychiatry 2019; 34:1892-1899. [PMID: 31469190 DOI: 10.1002/gps.5206] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/24/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Little research has explored how cognitive function and activities of daily living (ADL) affect each other over time. In addition, no current finding provides a clear hint to the temporal precedence between them. The present study tries to address these limitations of prior studies by utilizing a longitudinal data and advanced statistical modeling. METHODS This study analyzed the data from the China Health and Retirement Longitudinal Study (CHARLS), a prospective observational study performed every 2 years for a total of three waves between 2011 and 2015 using a multistage probability sampling. Cognitive function was measured on the basis of three aspects of cognitive performance. Functional abilities were assessed using six types of activities of ADL and five types of instrumental ADL (IADL). Latent difference score modeling was employed to investigate the temporal precedence between cognitive function and ADL. RESULTS The best fitting model indicates poor cognitive function precede worsening in ADL function, whereas the current findings did not support that poor ADL predate the cognition decline or reciprocal influence hypotheses. CONCLUSIONS The elderly with poor cognitive function may be more vulnerable to deterioration in ADL. Findings underscore the importance of early screening for cognitive function among the elderly as the key strategy to prevent further ADL impairment and keep independence.
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Affiliation(s)
- Juan Wang
- School of Public Health, Guangzhou Medical University, Guangzhou, China.,Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei-Heng Zhu
- College of information science and technology, Jinan University, Guangzhou, China
| | - You-Fu Li
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei-Wen Zhu
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Li Y, Zhang H, Wang Y. Tai Chi Ameliorates Coronary Heart Disease by Affecting Serum Levels of miR-24 and miR-155. Front Physiol 2019; 10:587. [PMID: 31191331 PMCID: PMC6548805 DOI: 10.3389/fphys.2019.00587] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 04/26/2019] [Indexed: 12/17/2022] Open
Abstract
The protective role of Tai Chi in coronary heart disease (CHD) has been widely reported. However, the exact molecular mechanism remains unclear. Serum levels of miR-24 and miR-155 have been found to potentially be involved with CHD risk. Thus, the effects of Tai Chi on CHD risk were explored by measuring serum levels of miR-24 and miR-155. A total of 326 CHD patients were evenly divided into the Tai Chi (TG) and control (CG) groups. The activities of daily living ability (ADL) and exercise of self-care agency (ESCA) scores were compared between the two groups. Left ventricular ejection fraction (LVEF), SF-36 life quality, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate subjects’ cardiac function, quality of life, anxiety, and depression. Serum levels of miR-24 and miR-155 were measured by a real-time quantitative polymerase chain reaction (RT-qPCR). After a 6-month Tai Chi intervention, the ESCA, ADL, LVEF, and SF-36 scores in the TG group were higher than those in the CG group (p < 0.05). The time of arrhythmia and atrioventricular block recovery and hospital stay, and the scores of SAS and SDS in the TG group were lower than in the CG group (p < 0.05). Serum levels of miR-24 and miR-155 in the TG group were also lower than in the CG group (p < 0.05). In addition, serum levels of miR-24 and miR-155 were negatively associated with the ESCA, ADL, LVEF and SF-36 scores, and had adverse effects on life quality. Altogether, these present findings demonstrate that Tai Chi improves CHD prognosis, by affecting serum levels of the miR-24 and miR-155.
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Affiliation(s)
- Yang Li
- Department of Cardiovascular Center, The First Bethune Hospital of Jilin University, Changchun, China
| | - Haiyang Zhang
- Department of Cardiovascular Center, The First Bethune Hospital of Jilin University, Changchun, China
| | - Yushi Wang
- Department of Cardiovascular Center, The First Bethune Hospital of Jilin University, Changchun, China
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Abstract
UNLABELLED ABSTRACTBackground:Mind-body interventions have been associated with a range of positive outcomes in older adults with mild cognitive impairment (MCI). The aim of the present study was to review the impact of different non-pharmacological programs based on mind-body intervention for older adults with MCI. METHODS A comprehensive search method as required by the Cochrane Collaboration has been performed through the following databases: Google Scholar, Science Direct, PubMed, PsycINFO, MEDLINE, EMBASE, CINHAL, Cochrane, Ebsco. We included the studies that evaluated the impact of mind-body interventions such as mindfulness or meditation, yoga, Tai Chi and Qigong on cognitive function and everyday functionality of non-hospitalized adults aged 55 years or over with MCI. RESULTS Nine studies met the inclusion criteria. Results indicated that mind-body interventions improved cognitive function, everyday activities functioning, and mindfulness, as well as resulting in a moderate reduction in fall risk, depression and stress and lower risk of dementia at one year. CONCLUSION Several mind-body interventions focused broadly on mindfulness, yoga and Tai Chi training have been studied. This review shows that mind-body interventions improved cognitive function and everyday activities functioning, memory, resilience and mindfulness in older adults with MCI. However, the conclusions faced limitations, such as small sample size, heterogeneity of outcome measures, lack of an active control group and absence of long-term follow up. Further high-quality evidence is needed in order to determine whether mind-body interventions are cost-effective for improving cognitive decline in older adults with MCI and for delaying the rapid progression from MCI to Alzheimer or other types of dementia.
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Zou L, Loprinzi PD, Yeung AS, Zeng N, Huang T. The Beneficial Effects of Mind-Body Exercises for People With Mild Cognitive Impairment: a Systematic Review With Meta-analysis. Arch Phys Med Rehabil 2019; 100:1556-1573. [PMID: 30986409 DOI: 10.1016/j.apmr.2019.03.009] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/05/2019] [Accepted: 03/05/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To objectively evaluate the most common forms of mind-body exercise (MBE) (tai chi, yoga, qigong) on cognitive function among people with mild cognitive impairment (MCI). DATA SOURCES We searched 6 electronic databases (Scopus, PubMed, PsycINFO, WanFang, Web of Science, CNKI) from inception until September 2018. STUDY SELECTION Nine randomized controlled trials and 3 nonrandomized controlled trials were included for meta-analysis. DATA EXTRACTION Two researchers independently performed the literature searches, study selection, data extraction, and methodological quality assessment using the revised Physiotherapy Evidence Database (PEDro) scale. DATA SYNTHESIS The pooled effect size (standardized mean difference [SMD]) was calculated while random-effect model was selected. Overall results of the meta-analysis (N=1298 people with MCI) indicated that MBE significantly improved attention (SMD=0.39, 95% confidence interval [CI] 0.07-0.71, P=.02, I2=31.6%, n=245), short-term memory (SMD=0.74, 95% CI 0.57-0.90, P<.001, I2=0%, n=861), executive function (SMD=-0.42, 95% CI -0.63 to -0.21, P<.001, I2=38.54%, n=701), visual-spatial/executive function (SMD=0.35, 95% CI 0.07-0.64, P<.05, I2=0%, n=285), and global cognitive function (SMD=0.36, 95% CI 0.2-0.52, P<.001, I2=15.12%, n=902). However, the significant positive effect on cognitive processing speed was not observed following MBE interventions (SMD=0.31, 95% CI -0.01 to 0.63, P=.054, I2=28.66%, n=233). CONCLUSIONS Study findings of this meta-analysis suggest that MBE have the potential to improve various cognitive functions in people with MCI.
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Affiliation(s)
- Liye Zou
- Lifestyle (Mind-Body Movement) Research Center, College of Sport Science, Shenzhen University, Shenzhen, China.
| | - Paul D Loprinzi
- Exercise & Memory Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, Oxford, Mississippi
| | - Albert S Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts
| | - Nan Zeng
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado
| | - Tao Huang
- Department of Physical Education, Shanghai Jiaotong University, Shanghai, China
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Zhou S, Zhang Y, Kong Z, Loprinzi PD, Hu Y, Ye J, Liu S, Yu JJ, Zou L. The Effects of Tai Chi on Markers of Atherosclerosis, Lower-limb Physical Function, and Cognitive Ability in Adults Aged Over 60: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050753. [PMID: 30832288 PMCID: PMC6427726 DOI: 10.3390/ijerph16050753] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/23/2019] [Accepted: 02/26/2019] [Indexed: 01/23/2023]
Abstract
Objective: The purpose of this study was to investigate the effects of Tai Chi (TC) on arterial stiffness, physical function of lower-limb, and cognitive ability in adults aged over 60. Methods: This study was a prospective and randomized 12-week intervention trial with three repeated measurements (baseline, 6, and 12 weeks). Sixty healthy adults who met the inclusion criteria were randomly allocated into three training conditions (TC-24, TC-42, and TC-56) matched by gender, with 20 participants (10 males, 10 females) in each of the three groups. We measured the following health outcomes, including markers of atherosclerosis, physical function (leg power, and static and dynamic balance) of lower-limb, and cognitive ability. Results: When all three TC groups (p < 0.05) have showed significant improvements on these outcomes but overall cognitive ability at 6 or 12 weeks training period, TC-56 appears to have superior effects on arterial stiffness and static/dynamic balance in the present study. Conclusions: Study results of the present study add to growing body of evidence regarding therapeutic TC for health promotion and disease prevention in aging population. Future studies should further determine whether TC-42 and TC-56 are beneficial for other non-Chinese populations, with rigorous research design and follow-up assessment.
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Affiliation(s)
- Shengwen Zhou
- Department of Chinese Martial Arts, College of Sport Science, Hunan University of Science and Technology, Yongzhou 425100, China.
| | - Yanjie Zhang
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seuoul 08826, Korea.
| | - Zhaowei Kong
- Faculty of Education, University of Macau, Macao, China.
| | - Paul D Loprinzi
- Department of Health, Exercise Science and Recreation Management School of Applied Sciences, The University of Mississippi, Oxford, MS 36877, USA.
| | - Yang Hu
- Sports Science Research Center, Beijing Sport University, Beijing 100084, China.
| | - Jiajie Ye
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hunghom, Hong Kong, China.
| | - Shijie Liu
- Department of Physical Education, Wuhan University of Technology, Wuhan 430070, China.
| | - Jane Jie Yu
- Sports and Exercise Psychology Laboratory, Department of Sports, Science and Physical Education, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.
| | - Liye Zou
- Lifestyle (Mind-Body Movement) Research Center, College of Sports Science, Shenzhen University, Shenzhen 518060, China.
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Zhang Q, Hu J, Wei L, Cao R, Ma R, Song H, Jin Y. Effects of traditional Chinese exercise on cognitive and psychological outcomes in older adults with mild cognitive impairment: A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e14581. [PMID: 30762810 PMCID: PMC6408103 DOI: 10.1097/md.0000000000014581] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/28/2018] [Accepted: 01/24/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) can be a stage of pre-dementia. Although the traditional Chinese exercise (TCE) has benefits associated with cognitive functions, the effects of the TCE on cognitive functions of older patients with MCI remain controversial. This study performs a meta-analysis to quantify the efficiency of TCE for older individuals on cognitive and psychological outcomes. METHODS A comprehensive database search was conducted on PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCO), Web of Science, and four Chinese medical databases. We included trials published up to April 22, 2018, that fulfilled our inclusion and exclusion criteria. The literature was screened, the data were extracted and the methodological quality of the included trials was assessed. Meta-analyses were performed on the included data. RESULTS A total of 803 patients from 5 trials were included in our meta-analysis. Overall, there were no significant differences in global cognitive functions (P = .06), memory (P = .11), executive function (P = .74), Verbal fluency (P = .45) and depression (P = .89) between the TCE and the control groups. However, the TCE significantly improved the visuospatial function (SMD = 0.38, 95% CI = 0.22 to 0.54; P < .001) for individuals with MCI. CONCLUSIONS The findings of this study suggested that the TCE was associated with significant improvement in visuospatial function but did not affect the global cognitive functions, depression and other specific cognitive domains. There is a lack of clear evidence for effects of TCE; further large, rigorously designed studies are needed.
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Affiliation(s)
- Qi Zhang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Jianan Hu
- The Department of Nursing, Children's Hospital of Shanxi/Woman Health Center of Shanxi, Taiyuan, Shanxi
| | - Lijiao Wei
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Ri Cao
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Ruishu Ma
- School of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine
| | - Huimin Song
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Yi Jin
- The Department of Nursing, Tianjin Huanhu Hospital, Tianjin, China
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Zhang Y, Li C, Zou L, Liu X, Song W. The Effects of Mind-Body Exercise on Cognitive Performance in Elderly: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2791. [PMID: 30544873 PMCID: PMC6313783 DOI: 10.3390/ijerph15122791] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/04/2018] [Accepted: 12/06/2018] [Indexed: 12/19/2022]
Abstract
Background: As the situation of cognitive aging is getting worse, preventing or treating cognitive decline through effective strategies is highly important. This systematic review aims to investigate whether mind-body exercise is an effective approach for treating cognition decline. Methods: Searches for the potential studies were performed on the eight electronic databases (MEDLINE, Scopus, Web of Science, SPORTDiscus, CINAHL, PsycArtilces, CNKI, and Wanfang). Randomized controlled trials (RCTs) examining the effect of mind-body exercise on cognitive performance in older adults were included. Data were extracted and effect sizes were pooled with 95% confidence intervals (95% CI) using random-effects models. The Physiotherapy Evidence Database Scale was employed to examine the study quality. Results: Nineteen RCTs including 2539 elders (67.3% female) with fair to good study quality were identified. Mind-body exercise, relative to control intervention, showed significant benefits on cognitive performance, global cognition (Hedges'g = 0.23), executive functions (Hedges'g = 0.25 to 0.65), learning and memory (Hedges'g = 0.37 to 0.49), and language (Hedges'g = 0.35). In addition, no significant adverse events were reported. Conclusion: Mind-body exercise may be a safe and effective intervention for enhancing cognitive function among people aged 60 years or older. Further research evidence is still needed to make a more conclusive statement.
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Affiliation(s)
- Yanjie Zhang
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul 08826, Korea.
- Physical Education Unit, School of Humanities and Social Science, the Chinese University of Hong Kong, Shenzhen 518172, China.
| | - Chunxiao Li
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 637551, Singapore.
| | - Liye Zou
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong 999077, China.
| | - Xiaolei Liu
- Academy of Martial Arts and Traditional Sports, Beijing Sports University, Beijing 100084, China.
| | - Wook Song
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul 08826, Korea.
- Institute on Aging, Seoul National University, Seoul 08826, Korea.
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Effects of Mind-Body Exercise on Cognitive Function in Older Adults With Cognitive Impairment: A Systematic Review and Meta-analysis. J Nerv Ment Dis 2018; 206:913-924. [PMID: 30507734 DOI: 10.1097/nmd.0000000000000912] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
To quantify the effects of mind-body exercise on cognitive function in older adults with cognitive impairment, we systematically searched five databases. Findings were analyzed according to the mean change of global cognition, memory, and executive function. Subgroup analyses were conducted based on the level of cognitive impairment and types of exercise. Thirteen studies were included. Analyses revealed that mind-body exercise was effective in promoting global cognition in individuals with cognitive impairment (standardized mean difference [SMD] = 0.61; 95% confidence interval, 0.21-1.00; p = 0.003), as well as in individuals with mild cognitive impairment (SMD = 0.46; 95% confidence interval, 0.06-0.85; p = 0.02) or dementia; dance was effective in promoting global cognition (SMD = 0.84; 95% confidence interval, 0.23-1.46; p = 0.007) and memory (SMD = 0.27; 95% confidence interval, 0.02-0.52; p = 0.04) in individuals with cognitive impairment, but tai chi was not. Nevertheless, additional well-designed randomized clinical trials are further needed.
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Lyu D, Lyu X, Zhang Y, Ren Y, Yang F, Zhou L, Zou Y, Li Z. Tai Chi for Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Physiol 2018; 9:983. [PMID: 30090071 PMCID: PMC6068268 DOI: 10.3389/fphys.2018.00983] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 07/04/2018] [Indexed: 11/28/2022] Open
Abstract
Background: Stroke is a major cause of poor health and has numerous complications. Tai Chi (TC) may have positive effects on the rehabilitation of stroke survivors, but recent clinical findings have not been included in previously published reviews. Objectives: We conducted this systematic review and meta-analysis to determine the effectiveness of all types of TC vs. conventional rehabilitation therapy for all aspects of stroke survivors' rehabilitation that have been studied. Method: We searched seven electronic literature databases (three in English, four in Chinese) and one clinical registry platform using established strategies to identify randomized controlled trials performed up to October 2017. Screening, quality assessment, and data collection were performed by two researchers separately, using the same standard. The results were analyzed using RevMan 5.3.0. The quality of evidence was evaluated with GRADEpro. Results: A total of 21 studies with 1,293 stroke survivors met inclusion criteria; 14 were included in the quantitative synthesis to evaluate four aspects and five outcomes. Nine studies indicated that TC was able to improve independent activities of daily living (ADL), especially TC vs. conventional rehabilitation therapy [mean difference (MD) [95% confidence interval (CI)] = 9.92 [6.82, 13.02], P < 0.00001]. Five studies reported significant effects of TC plus conventional rehabilitation therapy in increasing scores on the Fugl-Meyer Assessment for the upper limb [MD (95%CI) = 8.27 [4.69, 11.84], P < 0.0001], lower limb [MD (95%CI) = 2.75 [0.95, 4.56], P = 0.003], and overall [MD (95%CI) = 4.49 [1.92, 7.06], P = 0.0006]. The Berg Balance Scale revealed significant improvements according to pooled estimates for TC vs. conventional rehabilitation therapy [MD (95%CI) = 5.23 [3.42, 7.05], P < 0.00001]. TC plus conventional rehabilitation therapy also improved walking ability as measured by the Holden scale [MD (95%CI) = 0.61 [0.38, 0.85], P < 0.00001] and up-and-go time [MD (95%CI) = 2.59 [1.76, 3.43], P < 0.00001]. Conclusion: TC has an overall beneficial effect on ADL, balance, limb motor function, and walking ability among stroke survivors, based on very low-quality evidence, and may also improve sleep quality, mood, mental health, and other motor function. Well-designed, higher-quality trials with longer-term follow-up periods are needed to develop better-quality evidence.
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Affiliation(s)
- Diyang Lyu
- Neurological Rehabilitation Center, Beijing Rehabilitation Hospital, The Affiliated Hospital of Capital Medical University, Beijing, China
- Department of Rehabilitation, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Xuanxin Lyu
- Neurological Rehabilitation Center, Beijing Rehabilitation Hospital, The Affiliated Hospital of Capital Medical University, Beijing, China
| | - Yong Zhang
- Department of Rehabilitation, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Yi Ren
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Fan Yang
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Li Zhou
- Department of Rehabilitation, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Yihuai Zou
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Zongheng Li
- Department of Rehabilitation, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
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Gheysen F, Poppe L, DeSmet A, Swinnen S, Cardon G, De Bourdeaudhuij I, Chastin S, Fias W. Physical activity to improve cognition in older adults: can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis. Int J Behav Nutr Phys Act 2018; 15:63. [PMID: 29973193 PMCID: PMC6032764 DOI: 10.1186/s12966-018-0697-x] [Citation(s) in RCA: 150] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/25/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Aging-related cognitive decline and cognitive impairment greatly impacts older adults' daily life. The worldwide ageing of the population and associated wave of dementia urgently calls for prevention strategies to reduce the risk of cognitive decline. Physical activity (PA) is known to improve cognitive function at older age through processes of neuroplasticity. Yet, emerging studies suggest that larger cognitive gains may be induced when PA interventions are combined with cognitive activity (CA). This meta-analysis evaluates these potential synergistic effects by comparing cognitive effects following combined PA + CA interventions to PA interventions (PA only), CA interventions (CA only) and control groups. METHODS Pubmed, Embase, PsycInfo, CINAHL and Sportdiscus were searched for English peer-reviewed papers until April 2018. Data were extracted on cognition and factors potentially influencing the cognitive effects: mode of PA + CA combination (sequential or simultaneous), session frequency and duration, intervention length and study quality. Differences between older adults with and without mild cognitive impairments were also explored. RESULTS Forty-one studies were included. Relative to the control group, combined PA + CA intervention showed significantly larger gains in cognition (g = 0.316; 95% CI 0.188-0.443; p < .001). Studies that compared combined PA + CA with PA only, showed small but significantly greater cognitive improvement in favor of combined interventions (g = 0.160; 95% CI 0.041-0.279; p = .008). No significant difference was found between combined PA + CA and CA only interventions. Furthermore, cognitive effects tended to be more pronounced for studies using simultaneous designs (g = 0.385; 95%CI 0.214-0.555; p < .001) versus sequential designs (g = 0.114; 95%CI -0.102- 0.331, p = .301). Effects were not moderated by session frequency, session duration, intervention length or study quality. Also, no differences in effects were found between older adults with and without mild cognitive impairments. CONCLUSION Findings of the current meta-analysis suggest that PA programs for older adults could integrate challenging cognitive exercises to improve cognitive health. Combined PA + CA programs should be promoted as a modality for preventing as well as treating cognitive decline in older adults. Sufficient cognitive challenge seems more important to obtain cognitive effects than high doses of intervention sessions.
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Affiliation(s)
- Freja Gheysen
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Louise Poppe
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Ann DeSmet
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Stephan Swinnen
- Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | - Sebastien Chastin
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Institute of Applied Health Research, School of Health and Life Science, Glasgow Caledonian University, Glasgow, UK
| | - Wim Fias
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
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