Biological Sex: A Potential Moderator of Physical Activity Efficacy on Brain Health

The COVID-19 pandemic's effects on cognition and 24-hour movement behaviours: Findings from the CLSA

BACKGROUND

The COVID-19 pandemic may have negatively impacted cognition due to pandemic-associated changes in 24-h movement behaviours (i.e., physical activity, sedentary behaviour, and sleep). Whether the pandemic's effects vary by age and sex is unclear.

METHODS

We examined those participants (aged 45-85 years) of the Canadian Longitudinal Study on Aging (CLSA) with complete neuropsychological measures at baseline (2011-2015), no dementia/memory disorder, and partial or complete assessments at baseline, 3-year (FU1; 2015-2018), and 6-year follow-up (FU2; 2018-2021). Participants were categorized into pre-pandemic (N = 6174) or intra-pandemic (N = 5181) cohorts by FU2 assessment timing (before/after March 11th, 2020) and stratified by baseline age/sex. Cognition was measured with reliable change indices using: the Rey Auditory-Verbal Learning Test, Mental Alternation Test (MAT), and animal fluency. We indexed physical activity and sedentary behaviour using the Physical Activity Scale for the Elderly (PASE), and self-reported restless sleep.

FINDINGS

Compared with their pre-pandemic peers, intra-pandemic men aged 65-85 years had lower animal fluency (-0.40 points, 99 % CI: [-0.72, -0.07]), lower PASE (-16.48 points, 99 % CI: [-24.60, -8.36]) and 14 % higher probability of ≥4 h/day sedentary behaviour (99 % CI: [0.03, 0.26]) at FU2. Intra-pandemic women aged 65-85 years had lower MAT (-0.43 points, 99 % CI: [-0.86, -0.01]) and 12 % higher probability of ≥4 h/day sedentary behaviour (99 % CI: [0.01, 0.23]). There were no between-cohort differences for those aged 45-64 years. Pandemic-related changes in 24-h movement behaviours (FU1 to FU2) were not associated with cognitive changes, regardless of age or sex.

INTERPRETATION

The pandemic's effects on cognition and 24-h movement behaviours varied by age and sex; these effects are unrelated.

Sex-specific effects of intensity and dose of physical activity on BOLD-fMRI cerebrovascular reactivity and cerebral pulsatility

Cerebrovascular reactivity (CVR) and cerebral pulsatility (CP) are important indicators of cerebrovascular health, which are associated with physical activity (PA). While sex differences influence the impact of PA on cerebrovascular health, sex-specific effects of PA intensity and dose on CP and CVR remains unknown. This study aimed to evaluate the sex-specific effects of self-reported PA dose and intensity on CVR and CP. The Human Connectome Project - Aging dataset was used, including 626 participants (350 females, 276 males) aged 36-85. The effect of menopausal status was also assessed. Resting state fMRI data was used to estimate both CVR and CP. Weekly self-reported PA was quantified as metabolic equivalent of task. Females presented a unique non-linear relationship between relative CVR and total PA in the cerebral cortex. Females and menopausal subgroups revealed negative linear relationships with total and walking PA in occipital and cingulate regions. Males exhibited negative linear relationships between total and vigorous PA and CVR in parietal and cingulate regions. Postmenopausal females showed greater reductions across more regions in CP than other groups. Overall, males and females appear to benefit from different amounts and intensities of PA, with menopause status influencing the effect of PA on cerebrovascular health.

Physical Activity or Inactivity and Fatigue in Children and Adolescents: A Cross-Sectional Study

Background/Objectives: Physical inactivity needs to be strategically addressed throughout adolescence because it is often accompanied by an alteration in the quality of life. Fatigue is one of the most common symptoms encountered in medical practice. However, little is known about the causal relationship between lifestyle and fatigue. The purpose of this study was to describe the prevalence of fatigue among children and adolescents and to investigate whether various sport types and training volume/week are related to increased fatigue over time while considering gender and age. Methods: A total of 1617 participants (mean age = 13.3 ± 1.9 years, 8.2 to 16.1) completed a questionnaire assessing their perception of fatigue and including questions regarding weekly physical practices and attitudes toward sports and health. The participants were secondary school students, whether or not they practiced sports, leisure activities, or music. Analyses of variance and Newman-Keul post-hoc tests were applied to assess differences between groups. A mediation model was used to determine the relationship between physical activity and fatigue score with the relevant role of mediating factors (physical activity level or physical activity type). Results: Older adolescents had significantly higher scores of fatigue than younger ones (28.9 ± 17.5 vs. 25.6 ± 16.6; p < 0.01). Girls had significantly higher scores of fatigue than boys (30.7 ± 17.5 vs. 23.8 ± 15.8; p < 0.001). Additionally, 10.7% of participants were sedentary and presented significantly higher scores of fatigue than participants in the Leisure (35.1 ± 18.2 vs. 29.4 ± 17.3; p < 0.001) and Sport groups (35.1 ± 18.2 vs. 25.3 ± 16.2; p < 0.0001). In the sedentary group, low physical activity was associated with a high score of fatigue; but in the Sport group, high physical activity was associated with a low score of fatigue. Conclusions: Fatigue is closely related to health, physical activity volume, gender, and age. Fatigue symptoms obtained through a questionnaire assessment can serve as an important index for health evaluation.

Isolation and Immunomodulatory Activity of Cyanidin-3-O-(3,6-O-dimalonyl-β-D-glucoside) from the Black Corncob (Zea mays L.) and its Effect on Gut Microbiota in Elderly Feces under Anaerobic Conditions in vitro

Black corn (Zea mays L.), native to Latin America, has been cultivated for millennia and holds significant cultural and culinary importance. While anthocyanins are well-characterized flavonoids in black corn, acylated derivatives remain insufficiently explored. Here, this study isolated a cyanidin derivative with two malonyl groups from black corncobs, identified as cyanidin-3-O-(3,6-O-dimalonyl-b-D-glucoside) (C3GdM) by mass spectrometry. The effects of C3GdM on the gut microbiota of the elderly and its immunomodulatory activity were examined in vitro. The findings revealed that C3GdM markedly improved gut microbiota composition, promoting beneficial bacteria growth such as Bifidobacterium and Lactobacillus while suppressing harmful bacteria like Escherichia/Shigella. Correspondingly, C3GdM elevated the levels of short-chain fatty acids in the feces of the elderly. Additionally, C3GdM upregulated genes associated with anti-inflammatory responses and antioxidant capacity in the elderly gut microbiota. In lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages, C3GdM reduced nitric oxide, tumor necrosis factor-a and interleukin-6, along with their mRNA expression. Thus, C3GdM is a promising candidate for remodeling gut microbiota in the aging population.

Effects of exercise and transient estradiol exposure in middle-aged female rats

The benefits of estrogen treatment on cognition in middle-aged and older women are dependent on many factors, including the timing of treatment. Moreover, the potential interactive effects with other lifestyle factors, such as exercise, are poorly understood. In this study, we tested for lasting benefits of independent and combined treatment with estrogen and voluntary exercise initiated in midlife, using a rat model of menopause. Twelve-month-old, retired female breeders were bilaterally ovariectomized and received six weeks of 17β-estradiol (E2) treatment via subcutaneous implant, with or without access to running wheels. After E2 treatment, animals in the exercise groups had running wheel access for seven additional weeks, including a two-week period of cognitive and affective testing. Thereafter, hippocampal neuronal and cellular plasticity were assessed. E2 and exercise independently exerted effects on behavioral and cellular outcome measures. Transient E2 treatment enduringly increased motor output, lowered body weight, and increased behavioral plasticity. Exercise decreased total hippocampal microglia number and increased brain weight. No additive effects of exercise and E2 treatment were observed. E2 treatment may provide a means by which to enduringly increase physical activity in middle age, but combined E2 and exercise do not produce additive benefits on hippocampal behavioral or cellular plasticity.

Age and Sex-Related Differences in Neuroprotective Effects of Cardiovascular Endurance on Cortical Thickness and Brain Volume in Adults Across Age

BACKGROUND

Higher cardiorespiratory fitness and cardiovascular endurance (CE) have been shown to be neuroprotective in older adulthood, but the mechanisms underlying this neuroprotection across the adult lifespan are poorly understood. The current study sought to examine the neuroprotective effects of CRF on gray matter (GM) and white matter (WM) volumes, and mean cortical thickness (MCT), using a large sample across the adult lifespan. We also examined sex differences in these relationships.

METHODS

This cross-sectional study included data from 1691 adults across the adult lifespan (22-100 years) from the Human Connectome Project Young Adults and Aging data. 2-minute walk test performance was used as a proxy of CE. Structural MRI was used to assess total GM volume, WM volume, and MCT. Linear regression models were used to examine the interaction between age and CE on total GM volume, WM volume, and MCT after adjusting for sex, years of education, body mass index, systolic blood pressure, gait speed, and total intracranial volume. Whole-brain surface-based analysis was also performed to investigate regional effects. Finally, interactions between age, sex, and CE were examined to test sex differences. p < 0.05, two-sided test, was designed as statistically significant.

RESULTS

With greater CE, the associations between greater age and lower total and regional GM and WM volumes and MCT were attenuated in whole sample. In men, age was associated with lower total GM volume and MCT regardless of CE level. In women, attenuated negative associations between age and total GM volume and MCT were found in those with high CE.

CONCLUSION

Greater CE over the adult lifespan is associated with preservation of cortical thickness and brain volume, particularly in women.

Cardiorespiratory fitness, hippocampal subfield morphology, and episodic memory in older adults

Objective

Age-related hippocampal atrophy is associated with memory loss in older adults, and certain hippocampal subfields are more vulnerable to age-related atrophy than others. Cardiorespiratory fitness (CRF) may be an important protective factor for preserving hippocampal volume, but little is known about how CRF relates to the volume of specific hippocampal subfields, and whether associations between CRF and hippocampal subfield volumes are related to episodic memory performance. To address these gaps, the current study evaluates the associations among baseline CRF, hippocampal subfield volumes, and episodic memory performance in cognitively unimpaired older adults from the Investigating Gains in Neurocognition Trial of Exercise (IGNITE) (NCT02875301).

Methods

Participants (N = 601, ages 65-80, 72% female) completed assessments including a graded exercise test measuring peak oxygen comsumption (VO2peak) to assess CRF, cognitive testing, and high-resolution magnetic resonance imaging of the hippocampus processed with Automated Segmentation of Hippocampal Subfields (ASHS). Separate linear regression models examined whether CRF was associated with hippocampal subfield volumes and whether those assocations were moderated by age or sex. Mediation models examined whether hippocampal volumes statistically mediated the relationship between CRF and episodic memory performance. Covariates included age, sex, years of education, body mass index, estimated intracranial volume, and study site.

Results

Higher CRF was significantly associated with greater total left (B = 5.82, p = 0.039) and total right (B = 7.64, p = 0.006) hippocampal volume, as well as greater left CA2 (B = 0.14, p = 0.022) and dentate gyrus (DG; B = 2.34, p = 0.031) volume, and greater right CA1 (B = 3.99, p = 0.011), CA2 (B = 0.15, p = 0.002), and subiculum (B = 1.56, p = 0.004) volume. Sex significantly moderated left DG volume (B = -4.26, p = 0.017), such that the association was positive and significant only for males. Total left hippocampal volume [indirect effect = 0.002, 95% CI (0.0002, 0.00), p = 0.027] and right subiculum volume [indirect effect = 0.002, 95% CI (0.0007, 0.01), p = 0.006] statistically mediated the relationship between CRF and episodic memory performance.

Discussion

While higher CRF was significantly associated with greater total hippocampal volume, CRF was not associated with all underlying subfield volumes. Our results further demonstrate the relevance of the associations between CRF and hippocampal volume for episodic memory performance. Finally, our results suggest that the regionally-specific effects of aging and Alzheimer's disease on hippocampal subfields could be mitigated by maintaining higher CRF in older adulthood.

Sex Differences in Blood Accumulation of Neurodegenerative-Related Proteins and Antioxidant Responses to Regular Physical Exercise

Physical activity has been demonstrated to improve cognitive function, thereby preventing/slowing neurodegenerative diseases (NDs). Biological responses to physical activity and vulnerabilities to NDs are emerging to be gender-related. Herein, known ND-associated markers (β-amyloid, tau, α-synuclein), main sex steroid hormones, antioxidant responses, and key gene transcription modulators were evaluated in the blood of physically active and sedentary women and men. In our hands, females presented higher basal erythrocytes β-amyloid and α-synuclein amounts than males. Regular physical activity was able to significantly reduce the erythrocyte content of β-amyloid in females and the tau levels in males, suggesting that these differences may be mediated by organizational actions of sex steroid hormones during development. Furthermore, despite a comparable plasma antioxidant capability (AOC) between males and females, in the latter group, physical activity significantly enhances AOC versus peroxynitrite radicals only. Finally, regular physical activity modulated the levels of transcription factor Nrf2 in erythrocytes, as well as the plasma concentration of the microRNA miR-195 and miR-153, suggesting the promotion of antioxidant/autophagic processes associated with ND-related proteins. Overall, these results could shed light on how cerebral adaptations to physical activity differ between males and females, especially with regard to blood accumulation of ND proteins and mechanisms of antioxidant responses to regular exercise.

Dose response of leisure time physical activity and biological aging in type 2 diabetes: a cross sectional study

To investigate the relationship between Leisure time physical activity (LTPA) patterns and PhenoAgeAccel in patients with Type 2 diabetes (T2D), emphasizing the role of regular LTPA in mitigating biological aging. This study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, including 4,134 adults with T2D. Multivariable linear regression models and restricted cubic spline (RCS) methods were employed to assess the relationship between LTPA and Phenotypic age acceleration (PhenoAgeAccel), with segmented likelihood ratio tests to detect nonlinear thresholds. Stratified regression and interaction tests were conducted for robust analysis. Compared to individuals with no LTPA patterns, those with regular LTPA patterns had significantly lower PhenoAgeAccel scores (β = -1.164, 95% CI: -1.651 to -0.677, P < 0.0001), while the "Weekend Warrior" and "Inactive-LTPA" patterns showed no significant effects. A nonlinear threshold effect was identified; below 594.57 min of weekly LTPA, there was a significant negative correlation (β = -0.002, 95% CI: -0.003 to -0.001, P = 0.000), with gender-specific effects present. Regular LTPA significantly reduces phenotypic age acceleration in T2D patients, with a nonlinear threshold effect indicating that moderate physical activity is most beneficial. These findings highlight the necessity of personalized physical activity recommendations and provide evidence for public health strategies to promote healthy aging in T2D patients.

Sex-specific effects of intensity and dose of physical activity on BOLD-fMRI cerebrovascular reactivity and cerebral pulsatility

Cerebrovascular reactivity (CVR) and cerebral pulsatility (CP) are important indicators of cerebrovascular health and have been shown to be associated with physical activity (PA). Sex differences have been shown to influence the impact of PA on cerebrovascular health. However, the sex-specific effects of PA on CP and CVR, particularly in relation to intensity and dosage of PA, remains unknown. Thus, this cross-sectional study aimed to evaluate the sex-specific effects of different intensities and doses of PA on CVR and CP. The Human Connectome - Aging dataset was used, including 626 participants (350 females, 276 males) aged 36-85 (mean age: 58.8 ± 14.1 years). Females were stratified into premenopausal and postmenopausal groups to assess the potential influence of menopausal status. Novel tools based solely on resting state fMRI data were used to estimate both CVR and CP. The International Physical Activity Questionnaire was used to quantify weekly self-reported PA as metabolic equivalent of task. Results indicated that both sexes and menopausal subgroups revealed negative linear relationships between relative CVR and PA. Furthermore, females presented a unique non-linear relationship between relative CVR and total PA in the cerebral cortex. In females, there were also relationships with total and walking PA in occipital and cingulate regions. In males, we observed relationships between total or vigorous PA and CVR in parietal and cingulate regions. Sex-specific effects were also observed with CP, whereby females benefited across a greater number of regions and intensities than males, especially in the postmenopause group. Overall, males and females appear to benefit from different amounts and intensities of PA, with menopause status significantly influencing the effect of PA on cerebrovascular outcomes, underscoring the need for sex-specific recommendations in promoting cerebrovascular health.

The Hidden Dangers of Sedentary Living: Insights into Molecular, Cellular, and Systemic Mechanisms

With the aging of the global population, neurodegenerative diseases are emerging as a major public health issue. The adoption of a less sedentary lifestyle has been shown to have a beneficial effect on cognitive decline, but the molecular mechanisms responsible are less clear. Here we provide a detailed analysis of the complex molecular, cellular, and systemic mechanisms underlying age-related cognitive decline and how lifestyle choices influence these processes. A review of the evidence from animal models, human studies, and postmortem analyses emphasizes the importance of integrating physical exercise with cognitive, multisensory, and motor stimulation as part of a multifaceted approach to mitigating cognitive decline. We highlight the potential of these non-pharmacological interventions to address key aging hallmarks, such as genomic instability, telomere attrition, and neuroinflammation, and underscore the need for comprehensive and personalized strategies to promote cognitive resilience and healthy aging.

The Best of Two Worlds to Promote Healthy Cognitive Aging: Definition and Classification Approach of Hybrid Physical Training Interventions

A healthy lifestyle can be an important prerequisite to prevent or at least delay the onset of dementia. However, the large number of physically inactive adults underscores the need for developing and evaluating intervention approaches aimed at improving adherence to a physically active lifestyle. In this regard, hybrid physical training, which usually combines center- and home-based physical exercise sessions and has proven successful in rehabilitative settings, could offer a promising approach to preserving cognitive health in the aging population. Despite its potential, research in this area is limited as hybrid physical training interventions have been underused in promoting healthy cognitive aging. Furthermore, the absence of a universally accepted definition or a classification framework for hybrid physical training interventions poses a challenge to future progress in this direction. To address this gap, this article informs the reader about hybrid physical training by providing a definition and classification approach of different types, discussing their specific advantages and disadvantages, and offering recommendations for future research. Specifically, we focus on applying digital technologies to deliver home-based exercises, as their use holds significant potential for reaching underserved and marginalized groups, such as older adults with mobility impairments living in rural areas.

The mind and motion: exploring the interplay between physical activity and Mild Behavioral Impairment in dementia-free older adults

Physical inactivity in mid-life is a modifiable risk factor for dementia. Mild behavioral impairment (MBI) is a marker of potential neurodegenerative disease. We investigated the association between physical activity and MBI. Baseline data from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behaviour, Function, and Caregiving in Aging (CAN-PROTECT) were used. Four categories of weekly physical activity (cardiovascular, mind-body, strength training, and physical labour) were derived from the Community Healthy Activities Model Program for Seniors questionnaire. MBI was measured using the MBI-Checklist. Multivariable negative binomial regressions modelled the association between the standardized physical activity duration and MBI severity, adjusted for age, sex, education, marital status, ethno cultural origin, occupation, hypertension, dyslipidemia, mobility, and body mass index. Every 1 SD increase in cardiovascular activity was associated with 8.42% lower MBI severity. In contrast, every 1 SD increase in physical labor duration was associated with 5.64% greater MBI severity. These associations were neither moderated by the frequency engaging in each physical activity nor by sex. Cardiovascular physical activity in older persons may reduce levels of non-cognitive dementia markers like MBI, comparable to effects seen in cognition, potentially modulating dementia risk.

Differential modulation of resting-state functional connectivity between amygdala and precuneus after acute physical exertion of varying intensity: indications for a role in affective regulation

Introduction

Physical activity influences psychological well-being. This study aimed to determine the impact of exercise intensity on psychological well-being and alterations in emotion-related brain functional connectivity (FC).

Methods

Twenty young, healthy, trained athletes performed a low- and high-intensity interval exercise (LIIE and HIIE) as well as a control condition in a within-subject crossover design. Before and after each condition, Positive And Negative Affect Scale (PANAS) was assessed as well as resting-state functional MRI (rs-fMRI). Voxel-wise FC was examined for bilateral amygdala seed region to whole-brain and emotion-related anatomical regions (e.g., insula, temporal pole, precuneus). Data analyses were performed using linear mixed-effect models with fixed factors condition and time.

Results

The PANAS Positive Affect scale showed a significant increase after LIIE and HIIE and a significant reduction in Negative Affect after the control condition. In rs-fMRI, no significant condition-by-time interactions were observed between the amygdala and whole brain. Amygdala-precuneus FC analysis showed an interaction effect, suggesting reduced post-exercise anticorrelation after the control condition, but stable, or even slightly enhanced anticorrelation for the exercise conditions, especially HIIE.

Discussion

In conclusion, both LIIE and HIIE had positive effects on mood and concomitant effects on amygdala-precuneus FC, particularly after HIIE. Although no significant correlations were found between amygdala-precuneus FC and PANAS, results should be discussed in the context of affective disorders in whom abnormal amygdala-precuneus FC has been observed.

Changes in cardiovascular health and white matter integrity with aerobic exercise, cognitive and combined training in physically inactive healthy late-middle-aged adults: the "Projecte Moviment" randomized controlled trial

INTRODUCTION

This is a 12-weeks randomized controlled trial examining the effects of aerobic exercise (AE), computerized cognitive training (CCT) and their combination (COMB). We aim to investigate their impact on cardiovascular health and white matter (WM) integrity and how they contribute to the cognitive benefits.

METHODS

109 participants were recruited and 82 (62% female; age = 58.38 ± 5.47) finished the intervention with > 80% adherence. We report changes in cardiovascular risk factors and WM integrity (fractional anisotropy (FA); mean diffusivity (MD)), how they might be related to changes in physical activity, age and sex, and their potential role as mediators in cognitive improvements.

RESULTS

A decrease in BMI (SMD = - 0.32, p = 0.039), waist circumference (SMD = - 0.42, p = 0.003) and diastolic blood pressure (DBP) (SMD = - 0.42, p = 0.006) in the AE group and a decrease in BMI (SMD = - 0.34, p = 0.031) and DBP (SMD = - 0.32, p = 0.034) in the COMB group compared to the waitlist control group was observed. We also found decreased global MD in the CCT group (SMD = - 0.34; p = 0.032) and significant intervention-related changes in FA and MD in the frontal and temporal lobes in the COMB group.

CONCLUSIONS

We found changes in anthropometric measures that suggest initial benefits on cardiovascular health after only 12 weeks of AE and changes in WM microstructure in the CCT and COMB groups. These results add evidence of the clinical relevance of lifestyle interventions and the potential benefits when combining them.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov NCT031123900.

Intrinsic functional brain connectivity changes following aerobic exercise, computerized cognitive training, and their combination in physically inactive healthy late-middle-aged adults: the Projecte Moviment

Lifestyle interventions have positive neuroprotective effects in aging. However, there are still open questions about how changes in resting-state functional connectivity (rsFC) contribute to cognitive improvements. The Projecte Moviment is a 12-week randomized controlled trial of a multimodal data acquisition protocol that investigated the effects of aerobic exercise (AE), computerized cognitive training (CCT), and their combination (COMB). An initial list of 109 participants was recruited from which a total of 82 participants (62% female; age = 58.38 ± 5.47) finished the intervention with a level of adherence > 80%. Only in the COMB group, we revealed an extended network of 33 connections that involved an increased and decreased rsFC within and between the aDMN/pDMN and a reduced rsFC between the bilateral supplementary motor areas and the right thalamus. No global and especially local rsFC changes due to any intervention mediated the cognitive benefits detected in the AE and COMB groups. Projecte Moviment provides evidence of the clinical relevance of lifestyle interventions and the potential benefits when combining them.

Associations of Physical Activity Engagement with Cerebral Amyloid-β and Tau from Midlife

Background

Higher midlife physical activity engagement has been associated with lower dementia risk in late life. However, the underlying mechanisms contributing to the protective effect remain unclear.

Objective

The goal of the current study was to evaluate the associations of physical activity with cerebral amyloid-β (Aβ) and tau in a predominately middle-aged community-based cohort, as well as to explore whether the associations differ by sex or age.

Methods

Participants from the Framingham Heart Study underwent 11C-Pittsburgh Compound B amyloid and 18F-Flortaucipir tau positron emission tomography (PET) imaging. Total physical activity levels were evaluated by self-report using the Physical Activity Index (PAI). Cross-sectional associations between total PAI with regional Aβ and tau PET retention were evaluated using linear regression models adjusted for demographic and cardiovascular risk factors. Interactions with sex and age group were examined and stratified analyses were performed when significant. FDR-correction for multiple comparisons was applied.

Results

The sample included 354 participants (mean age 53±8 years, 51% female). Higher total PAI scores were associated with lower entorhinal cortex tau PET binding (β (SE) = -0.021(0.008), p = 0.049). There were significant interactions with sex. In men alone, total PAI inversely associated with entorhinal cortex (β (SE) = -0.035(0.009), p = 0.001), inferior temporal (β (SE) = -0.029(0.010), p = 0.012), and rhinal cortex tau(β (SE) = -0.033(0.010), p = 0.002).

Conclusions

The results suggest that higher midlife physical activity engagement may confer resistance to tau pathology. However, the effects may vary based on sex, highlighting the importance of better understanding and tailoring lifestyle interventions to address sex disparities.

Exercise and Memory

Our memory is crucial to our daily functioning, our identity, and how we interact with the world around us. Maintaining memory functioning is therefore important in many ways. Exercise positively affects our memory. Even a single exercise session can directly boost different memory types, including working, procedural, and episodic memory. Due to these benefits, exercise has great potential as an intervention in different settings, such as schools or rehabilitation centers, and as a prevention strategy. In this chapter, we first give an overview of what memory is and why it is so relevant to our mental health. Next, we briefly discuss how, for whom, and under which circumstances exercise improves memory functioning. Then, we will summarize the literature of experimental studies investigating the direct effect of exercise on different memory types, while acknowledging current limitations and potential future directions. Finally, we briefly highlight the potential of exercise as intervention to preserve and improve memory.

Basal forebrain functional connectivity as a mediator of associations between cardiorespiratory fitness and cognition in healthy older women

Age-related cholinergic dysfunction within the basal forebrain (BF) is one of the key hallmarks for age-related cognitive decline. Given that higher cardiorespiratory fitness (CRF) induces neuroprotective effects that may differ by sex, we investigated the moderating effects of sex on the associations between CRF, BF cholinergic function, and cognitive function in older adults. 176 older adults (68.5 years) were included from the Nathan Kline Institute Rockland Sample. Functional connectivity (rsFC) of the BF subregions including the medial septal nucleus/diagonal band of Broca (MS/DB) and nucleus basalis of Meynert (NBM) were computed from resting-sate functional MRI. Modified Astrand-Ryhming submaximal cycle ergometer protocol was used to estimate CRF. Trail making task and inhibition performance during the color word interference test from the Delis-Kaplan Executive Function System and Rey Auditory Verbal Learning Test were used to examine cognitive function. Linear regression models were used to assess the associations between CRF, BF rsFC, and cognitive performance after controlling for age, sex, and years of education. Subsequently, we measured the associations between the variables in men and women separately to investigate the sex differences. There was an association between higher CRF and greater rsFC between the NBM and right middle frontal gyrus in older men and women. There were significant associations between CRF, NBM rsFC, and trail making task number-letter switching performance only in women. In women, greater NBM rsFC mediated the association between higher CRF and better trail making task number-letter switching performance. These findings provide evidence that greater NBM rsFC, particularly in older women, may be an underlying neural mechanism for the relationship between higher CRF and better executive function.

Effects of polyphenols and their metabolites on age-related diseases

Aging contributes to the progressive loss of cellular biological functions and increases the risk of age-related diseases. Cardiovascular diseases, some neurological disorders and cancers are generally classified as age-related diseases that affect the lifespan of individuals. These diseases result from the accumulation of cellular damage and reduced activity of protective stress response pathways, which can lead to inflammation and oxidative stress, which play a key role in the aging process. There is now increasing interest in the therapeutic effects of edible plants for the prevention of various diseases, including those associated with aging. It has become clear that the beneficial effects of these foods are due, at least in part, to the high concentration of bioactive phenolic compounds with low side effects. Antioxidants are the most abundant, and their high consumption in the Mediterranean diet has been associated with slower ageing in humans. Extensive human dietary intervention studies strongly suggest that polyphenol supplementation protects against the development of degenerative diseases, especially in the elderly. In this review, we present data on the biological effects of plant polyphenols in the context of their relevance to human health, ageing and the prevention of age-related diseases.

Data-driven physical actigraphy patterns relate to cognitive and vascular health in older adults

Health benefits of physical activity (PA) are well known; however, specific PA patterns that relate most strongly to cognitive aging outcomes are poorly understood. We characterized latent profiles of PA among older adults and examined associations with cognition and vascular burden. 124 functionally normal older adults wore a Fitbit™ for 30 days. Daily average step count, sedentary time (0 steps/min), and high-intensity time (≥120 steps/min) were calculated. Participants completed neurocognitive testing assessing cognitive domains of executive functioning and memory; medical history, from which vascular burden (i.e., a count of cardiovascular conditions) was calculated; and brain MRI (n = 44). Subgroups with similar PA patterns were identified via latent profile analysis. Three latent PA classes emerged: Class 1Low PA (n = 49), Class 2Average PA (n = 59), and Class 3High-intensity PA (n = 16). PA class related to executive functioning and vascular burden, driven by better outcomes in Class 3 than Class 1. Sex-stratified analyses revealed these associations were strongest in males. Post hoc analyses showed a positive association between high-intensity PA and white matter integrity among males. High-intensity PA related to better cognitive and vascular health, particularly among males. Findings inform physical activity-specific and person-specific recommendations for optimal cognitive aging.

Aerobic exercise improves executive functions in females, but not males, without the BDNF Val66Met polymorphism

BACKGROUND

Aerobic exercise promotes cognitive function in older adults; however, variability exists in the degree of benefit. The brain-derived neurotropic factor (BDNF) Val66Met polymorphism and biological sex are biological factors that have been proposed as important modifiers of exercise efficacy. Therefore, we assessed whether the effect of aerobic exercise on executive functions was dependent on the BDNFval66met genotype and biological sex.

METHODS

We used data from a single-blind randomized controlled trial in older adults with subcortical ischemic vascular cognitive impairment (NCT01027858). Fifty-eight older adults were randomly assigned to either the 6 months, three times per week progressive aerobic training (AT) group or the usual care plus education control (CON) group. The secondary aim of the parent study included executive functions which were assessed with the Trail Making Test (B-A) and the Digit Symbol Substitution Test at baseline and trial completion at 6 months.

RESULTS

Analysis of covariance, controlling for baseline global cognition and baseline executive functions performance (Trail Making Test or Digit Symbol Substitution Test), tested the three-way interaction between experimental group (AT, CON), BDNFval66met genotype (Val/Val carrier, Met carrier), and biological sex (female, male). Significant three-way interactions were found for the Trail Making Test (F(1,48) = 4.412, p < 0.04) and Digit Symbol Substitution Test (F(1,47) = 10.833, p < 0.002). Posthoc analyses showed female Val/Val carriers benefited the most from 6 months of AT compared with CON for Trail Making Test and Digit Symbol Substitution Test performance. Compared with CON, AT did not improve Trail Making Test performance in male Val/Val carriers or Digit Symbol Substitution Test performance in female Met carriers.

CONCLUSIONS

These results suggest that future randomized controlled trials should take into consideration BDNF genotype and biological sex to better understand the beneficial effects of AT on cognitive function in vascular cognitive impairment to maximize the beneficial effects of exercise and help establish exercise as medicine for cognitive health.

Effects of Exercise on Testosterone and Implications of Drug Abuse: A Review

OBJECTIVE

Research points to exercise having a positive effect in fighting relapse and use of drugs of abuse. Through conducting this research, differences have been observed in the effects of exercise on drug abuse between sexes. Many of the studies found that exercise tends to cause a more profound effect in blocking drug relapse or reinstatement in males when compared with females.

METHODS

Our hypothesis is that these differences in response to drugs of abuse after an exercise regimen could in part be attributed to variations in testosterone levels between males and females.

RESULTS

Testosterone has been shown to have a modulatory impact on the dopaminergic activity in the brain, causing an effect on the brain's response to drugs of abuse. Exercise has demonstrated a causal effect on increasing testosterone levels in males, whereas drugs of abuse decrease testosterone levels in males.

CONCLUSIONS

Thus, exercise raising testosterone levels in males helps to decrease the dopaminergic response in the brain to drugs of abuse causing attenuation to drugs. To find sex-specific exercise treatments for drugs of abuse, it is important to continue researching exercise's efficacy against drugs of abuse.

Use of Brain-Derived Stem/Progenitor Cells and Derived Extracellular Vesicles to Repair Damaged Neural Tissues: Lessons Learned from Connective Tissue Repair Regarding Variables Limiting Progress and Approaches to Overcome Limitations

Pluripotent neural stem or progenitor cells (NSC/NPC) have been reported in the brains of adult preclinical models for decades, as have mesenchymal stem/stromal cells (MSC) been reported in a variety of tissues from adults. Based on their in vitro capabilities, these cell types have been used extensively in attempts to repair/regenerate brain and connective tissues, respectively. In addition, MSC have also been used in attempts to repair compromised brain centres. However, success in treating chronic neural degenerative conditions such as Alzheimer's disease, Parkinson's disease, and others with NSC/NPC has been limited, as have the use of MSC in the treatment of chronic osteoarthritis, a condition affecting millions of individuals. However, connective tissues are likely less complex than neural tissues regarding cell organization and regulatory integration, but some insights have been gleaned from the studies regarding connective tissue healing with MSC that may inform studies attempting to initiate repair and regeneration of neural tissues compromised acutely or chronically by trauma or disease. This review will discuss the similarities and differences in the applications of NSC/NPC and MSC, where some lessons have been learned, and potential approaches that could be used going forward to enhance progress in the application of cellular therapy to facilitate repair and regeneration of complex structures in the brain. In particular, variables that may need to be controlled to enhance success are discussed, as are different approaches such as the use of extracellular vesicles from stem/progenitor cells that could be used to stimulate endogenous cells to repair the tissues rather than consider cell replacement as the primary option. Caveats to all these efforts relate to whether cellular repair initiatives will have long-term success if the initiators for neural diseases are not controlled, and whether such cellular initiatives will have long-term success in a subset of patients if the neural diseases are heterogeneous and have multiple etiologies.

Sex and BDNF Val66Met polymorphism matter for exercise-induced increase in neurogenesis and cognition in middle-aged mice

Females show greater benefits of exercise on cognition in both humans and rodents, which may be related to brain-derived neurotrophic factor (BDNF). A single nucleotide polymorphism (SNP), the Val66Met polymorphism, within the human BDNF gene, causes impaired activity-dependent secretion of neuronal BDNF and impairments to some forms of memory. We evaluated whether sex and BDNF genotype (Val66Met polymorphism (Met/Met) versus wild-type (Val/Val)) influenced the ability of voluntary running to enhance cognition and hippocampal neurogenesis in mice. Middle-aged C57BL/6J (13 months) mice were randomly assigned to either a control or an aerobic training (AT) group (running disk access). Mice were trained on the visual discrimination and reversal paradigm in a touchscreen-based technology to evaluate cognitive flexibility. BDNF Met/Met mice had fewer correct responses compared to BDNF Val/Val mice on both cognitive tasks. Female BDNF Val/Val mice showed greater cognitive flexibility compared to male mice regardless of AT. Despite running less than BDNF Val/Val mice, AT improved performance in both cognitive tasks in BDNF Met/Met mice. AT increased neurogenesis in the ventral hippocampus of BDNF Val/Val mice of both sexes and increased the proportion of mature type 3 doublecortin-expressing cells in the dorsal hippocampus of female mice only. Our results indicate AT improved cognitive performance in BDNF Met/Met mice and increased hippocampal neurogenesis in BDNF Val/Val mice in middle age. Furthermore, middle-aged female mice may benefit more from AT than males in terms of neuroplasticity, an effect that was influenced by the BDNF Val66Met polymorphism.

A Decade Later on How to "Use It" So We Don't "Lose It": An Update on the Unanswered Questions about the Influence of Activity Participation on Cognitive Performance in Older Age

Activity engagement is a modifiable factor that has been widely-cited as being good for the aging brain and cognition and represents a valuable target for reducing dementia risk. However, specific issues about activity engagement (mental, social, and physical) and cognition in older adulthood remain, and Bielak [Gerontology 2010;56: 507-519] reviewed seven major methodological and theoretical questions about this relationship. We present an updated reflection on these key questions, focusing on research published in the last 10 years. For some questions, a significant amount of work has been done and conclusions have become clearer; for others, there have been few additions to the literature and our knowledge remains much the same as it was a decade ago. We review the issues identified in the 2010 paper including the directionality and temporal nature of the relationship; whether specific activity domains offer different benefits to cognition and what domain(s) of cognition are affected; variation in the relation by age, gender, or education; potential mechanisms involved; and how activity engagement is assessed. For each, we present the most up-to-date research, discuss remaining challenges and possible future directions. This formal unifying of the information in the field is intended as a guide to support continued progress by spurring on studies addressing specific questions while reminding researchers of critical issues. We conclude with recommendations that future studies investigating the link between activity engagement and cognitive performance in adulthood should consider.

Do the relationships of physical activity and total sleep time with cognitive function vary by age and biological sex? A cross-sectional analysis of the Canadian Longitudinal Study on Aging

OBJECTIVES

Physical activity (PA) and total sleep time (TST) are each associated with cognition; however, whether these relationships vary by age and biological sex is unclear. We examined the relationships of PA or TST with cognition, and whether age and sex moderated these relationships, using baseline data from the Canadian Longitudinal Study on Aging (CLSA; 2010-2015).

STUDY DESIGN

A cross-sectional analysis of participants from the Comprehensive cohort of the CLSA with complete PA and sleep data (n = 20,307; age range 45-86 years).

MAIN OUTCOME MEASURES

PA and TST were measured using the Physical Activity Scale for the Elderly (PASE) and self-reported TST over the past month. Cognition was indexed using a three-factor structural equation model (i.e., memory, executive function, and verbal fluency).

RESULTS

Non-linear restricted cubic spline models indicated that PA and TST explained statistically significant (p < 0.01) but modest variance of each cognitive domain (<1 % of 23-24 % variance). Age and sex did not moderate associations of PA with any cognitive domain. However, age and sex moderated relationships of TST with cognition, whereby: 1) associations of TST with memory decreased with age for males and females; and 2) males and females had different age-associated relationships of TST with executive function and verbal fluency.

CONCLUSIONS

PA and TST modestly contribute to multiple domains of cognition across middle and older adulthood. Importantly, the association of PA with cognition does not appear to vary across middle or older adulthood, nor does it vary by biological sex; however, TST appears to have a complex relationship with multiple domains of cognition which is both age- and sex-dependent.

Memory Modulation by Exercise in Young Adults Is Related to Lactate and Not Affected by Sex or BDNF Polymorphism

Currently, high-intensity interval exercise (HIIE) is on the rise compared to moderate-intensity exercise (MIE) due to its similar benefits for health and performance with low time requirements. Recent studies show how physical exercise can also influence cognitive function, although the optimal dose and underlying mechanisms remain unknown. Therefore, in our study, we have compared the effects on visuospatial and declarative memory of different exercise intensities (HIIE vs. MIE), including possible implicated factors such as lactate released after each session and the Brain-Derived Neurotrophic Factor (BDNF) genotype. Thirty-six undergraduate students participated in this study. The HIIE session consisted of a 3 min warm-up, four 2 min sets at 90−95% of the maximal aerobic speed (MAS) with 2 min of passive recovery between sets, and a 3 min cooldown, and the MIE session implies the same total duration of continuous exercise at 60% of the MAS. Better improvements were found after HIIE than MIE on the backward condition of the visuospatial memory test (p = 0.014, ηp2 = 0.17) and the 48 h retention of the declarative memory test (p = 0.04; d = 0.34). No differences were observed in the forward condition of the visuospatial memory test and the 7-day retention of the declarative memory test (p > 0.05). Moreover, non-modifiable parameters such as biological sex and BDNF polymorphism (Val/Val, Val/Met, or Met/Met) did not modulate the cognitive response to exercise. Curiously, the correlational analysis showed associations (p < 0.05) between changes in memory (visuospatial and declarative) and lactate release. In this sense, our results suggest an important role for intensity in improving cognitive function with exercise, regardless of genetic factors such as biological sex or BDNF Val66Met polymorphism.

Effect of isometric handgrip exercise on cognitive function: Current evidence, methodology, and safety considerations

Cognitive function is essential for most behaviors of daily living and is a critical component in assessing the quality of life. Mounting prospective evidence supports the use of isometric handgrip exercise (IHE) as a small muscle mass practice to promote health-related outcomes in clinical and healthy populations. The aim of the present review was to systematically investigate whether IHE is effective in improving the cognitive function of adults (aged ≥18 years). Studies were identified by searching five databases (CINAHL, MEDLINE, SPORTDiscus, PsychINFO, and Web of Science). Eight out of 767 studies met the inclusion criteria, including three types of studies: 1) acute effect for IHE with various intensity protocols (n = 4); 2) acute effect for IHE with one set exhaustion protocol (n = 2); and 3) chronic effect of IHE on cognitive function (n = 2). To assess the methodological quality of studies, the PEDro scale was used (mean score = 6.75). The evidence on whether IHE exerts acute positive effects on cognitive performance is currently rather inconclusive. However, a trend was discernible that implementing IHE can generate a beneficial chronic effect on cognitive function, although the results should be interpreted with caution. The clinical relevance of IHE as a time-efficient type of physical exercise to improve cognitive function warrants further investigation. Methodology and safety considerations were discussed.

Systematic Review Registration: (https://osf.io/gbzp9).

Effects of Sport-Based Exercise Interventions on Executive Function in Older Adults: A Systematic Review and Meta-Analysis

Exercise programs of moderate-to-vigorous intensity have been shown to improve the cognitive performance of older people. However, the specific effects of sports-based exercise programs on cognitive performance, particularly executive functions, remain unclear. Therefore, the purpose of this study is to clarify the effects of sports-based exercise programs on executive functions in older adults using a systematic review and meta-analysis of the scientific literature. A systematic review was conducted between 1 March and 1 July 2022, to look for published scientific evidence that analyzed different sports programs that may have affected executive function in healthy older adults. Longitudinal studies, which assessed the effects of sports interventions on healthy older adults, were identified through a systematic search of the four principal electronic databases: Web of Science, PubMed, Scopus, and EBSCO. A total of nine studies with a total of 398 subjects met the inclusion criteria and were classified based on one or more of the following categories: working memory, inhibition, and cognitive flexibility. The DerSimonian and Laird random-effects model was performed using the Comprehensive Meta-Analysis software to facilitate the analysis of the studies. Statistical significance was set at p ≤ 0.05. In terms of working memory, a small but positive significant effect was noted for the intervention group compared to the control group (effect size (ES) = 0.35, 95% confidence interval (CI) = 0.04-0.67; p = 0.029; I² = 36.7%); in terms of inhibition, the intervention had a small favoring but no significant effect compared to the control group (ES = 0.20, 95% CI = -0.42-0.84; p = 0.517; I² = 78.8%); and in terms of cognitive flexibility, the intervention had a small favoring but no significant effect compared to the control group (ES = 0.39, 95% CI = -0.11-0.89; p = 0.131; I² = 75.5%). Our findings suggest that healthy older adults should be encouraged to participate in sports to improve their working memory; however, more studies are required in this area to reach more robust conclusions. This systematic review was registered with the International Prospective Register of Systematic Reviews (registration number: CRD42022284788).

Anti-aging effects and mechanisms of anthocyanins and their intestinal microflora metabolites

Aging, a natural and inevitable physiological process, is the primary risk factor for all age-related diseases; it severely threatens the health of individuals and places a heavy burden on the public health-care system. Thus, strategies to extend the lifespan and prevent and treat age-related diseases have been gaining increasing scientific interest. Anthocyanins (ACNs) are a subclass of flavonoids widely distributed in fruits and vegetables. Growing evidence suggests that ACNs delay aging and relieve age-related diseases. However, owing to the low bioavailability of ACNs, their gut metabolites have been proposed to play a critical role in mediating health benefits. In this review, we introduce the biological fate of ACNs after consumption and highlight ACNs metabolites (phenolic acids) from intestinal microorganisms. Additionally, ACNs and gut metabolites exhibit outstanding anti-aging ability in Caenorhabditis elegans, Drosophila melanogaster, and mouse models, probably associated with increasing antioxidation, anti-inflammation, protein homeostasis, antiglycation, mitochondrial function, and inhibition of insulin/IGF-1 signaling (IIS). ACNs and gut metabolites have great application prospects as functional foods and drugs to delay aging and manage age-related diseases. Further investigation should focus on the interaction between ACNs and gut microbiota, including clarifying the complex metabolic pathway and maximizing the health effects of ACNs.

Weight for It: Resistance Training Mitigates White Matter Hyperintensity-Related Disruption to Functional Networks in Older Females

Background: White matter hyperintensities (WMH) are associated with impaired cognition and increased falls risk. Resistance training (RT) is a promising intervention to reduce WMH progression, improve executive functions, and reduce falls. However, the underlying neurobiological process by which RT improves executive functions and falls risk remain unclear. We hypothesized that: 1) RT reduces the level of WMH-related disruption to functional networks; and 2) reduced disruption to the sensorimotor and attention networks will be associated with improved executive function and reduced falls risk. Objective: Investigate the impact of 52 weeks of RT on WMH-related disruption to functional networks. Methods: Thirty-two older females (65–75 years) were included in this exploratory analysis of a 52-week randomized controlled trial. Participants received either twice-weekly RT or balance and tone training (control). We used lesion network mapping to assess changes in WMH-related disruption to the sensorimotor, dorsal attention, and ventral attention networks. Executive function was measured using the Stroop Colour-Word Test. Falls risk was assessed using the Physiological Profile Assessment (PPA) and the foam sway test. Results: RT significantly reduced the level of WMH-related disruption to the sensorimotor network (p = 0.005). Reduced disruption to the dorsal attention network was associated with improvements in Stroop performance (r = 0.527, p = 0.030). Reduced disruption to the ventral attention network was associated with reduced PPA score (r = 0.485, p = 0.049) Conclusion: RT may be a promising intervention to mitigate WMH-related disruption to the sensorimotor network. Additionally, reducing disruption to the dorsal and ventral attention networks may contribute to improved executive function and reduced falls risk respectively.

Sex-specific longitudinal association between baseline physical activity level and cognitive decline in Chinese over 45 years old: Evidence from the China health and retirement longitudinal study

OBJECTIVES

To examine whether sex-specific associations between baseline PA level and follow up cognitive performance in Chinese subjects exist from the China Health and Retirement Longitudinal study (CHARLS).

METHOD

A total of 3395 adults aged 45 or old from the CHARLS were used for analysis. The combined scores of measurements of mental status and verbal episodic memory were utilized for assessing cognitive function at baseline in 2011 and the follow-up survey in 2015. Baseline PA level was quantified as the total PA score. Multiple linear regression and logistic regression models were used to examine the association between baseline PA status and global cognitive function and cognitive domains.

RESULTS

In the female subjects (n = 1748), compared with individuals of PA level in the lower tertile, those grouped into the upper tertile had the lowest risk of global cognitive decline [odds ratio (OR) =0.273, 95% confidence interval (CI) =0.077-0.960; p = 0.043] and verbal episodic memory decline [OR)=0.257, 95% CI =0.066-1.003; p = 0.051] from 2011 to 2015. However, no significant associations were observed in the male subjects (n = 1647).

CONCLUSION

In the female subjects, higher PA level was associated with reduced risk of cognitive decline within 4 years, this might be associated with reduced decline of verbal episodic memory. Our findings confirmed that female sex would positively affect the association between PA levels and cognitive decline.

Effects of Sport-Based Interventions on Executive Function in Older Adults: A Systematic Review and Meta-Analysis Protocol

Background: Moderate-to-vigorous intensity exercise programs have proven to exert positive effects on the cognitive performance of older people. However, the specific effects sport-based exercise programs have on cognitive performance, upon executive functions, remain unclear. Therefore, the purpose of this study is to clarify the effects of sport-based exercise programs on executive functions in older adults, through a systematic review protocol of the scientific literature, with a meta-analysis. Methods: The search was performed in the Web of Science, PubMed, Scopus, and EBSCO electronic databases by combining keywords and different medical subject headings (MeSH) to identify and evaluate the relevant studies from inception up until June 2022. This study considers longitudinal studies with at least one experimental group and pre- and post-intervention measurements involving healthy older adults of 60 years of age or older. Studies have to consider one or more measures of executive function, including dimensions of working memory, inhibition, and cognitive flexibility, in order to meet the eligibility criteria for inclusion in this report. The Physiotherapy Evidence Database (PEDro) scale was used for methodological quality assessment studies. The DerSimonian and Laird random-effects model was used to compute the meta-analyses and report effect sizes (ES, i.e., Hedges’ g) with 95% confidence intervals (95% CIs), and a statistical significance set at p ≤ 0.05. The ES values were calculated for executive function globally and for each dimension of executive function (e.g., working memory, inhibition, cognitive flexibility) in the experimental and control/comparator groups using the mean and standard deviation values before and after the intervention period. Conclusions: Our systematic review aims to clarify the effects of sport-based exercise programs on executive functions in older adults. The results may help practitioners and stakeholders to provide better evidence-based decisions regarding sport-based exercise program implementation for older adults, and to help them to optimize cognitive functions during the aging process. Ethical permission is not required for this study. Systematic review registration: this systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42022284788).

Lifestyle modification and cognitive function among individuals with resistant hypertension: cognitive outcomes from the TRIUMPH trial

BACKGROUND

Resistant hypertension is associated with increased risk of cognitive decline, stroke, and dementia. Lifestyle modification has been suggested to improve cognitive function through its salutary effects on vascular function.

METHODS

Participants included 140 patients with resistant hypertension participating in the TRIUMPH trial. Participants were randomized to a cardiac rehabilitation-based lifestyle program (C-LIFE) or a standardized education and physician advice condition (SEPA). Participants completed a 45-min cognitive test battery consisting of tests of Executive Functioning and Learning, Memory, and Processing Speed. Biomarkers of vascular [flow mediated dilation of the brachial artery (FMD)], microvascular, and cerebrovascular function were also collected, in addition to weight, fitness, and ambulatory blood pressure.

RESULTS

Participants averaged 63 years of age, 48% women, 59% black, and obese [mean BMI = 36 kg/m 2 (SD = 4)]. Cognitive performance improved across the entire cohort during the 4-month trial [ t -scores pretreatment = 48.9 (48, 50) vs. posttreatment = 50.0 (49, 51), P  < 0.001]. Postintervention Executive Function/Learning composite performance was higher for participants in C-LIFE compared to SEPA ( d  = 0.37, P  = 0.039). C-LIFE intervention effects on Memory and Processing Speed were moderated by sex and baseline stroke risk, respectively ( P  = 0.026 and P  = 0.043 for interactions), such that males and participants with greater stroke risk showed the greatest cognitive changes. FMD [C-LIFE: +0.3% (-0.3, 1.0) vs. SEPA: -1.4% (-2.5, -0.3), P  = 0.022], and microvascular function [C-LIFE: 97 (65, 130) vs. SEPA: 025 (-75, 23), P  < 0.001] were improved in C-LIFE compared with SEPA, whereas cerebrovascular reactivity was not [C-LIFE: -0.2 (-0.4, 0) vs. SEPA: 0.1 (-0.2, 0.4), P  = 0.197). Mediation analyses suggested that increased executive function/learning was associated with reduced ambulatory SBP levels secondary to weight loss [indirect effect: B  = 0.25 (0.03, 0.71)].

CONCLUSION

Lifestyle modification individuals with resistant hypertension improves cognition, which appeared to be associated with reduced ambulatory SBP changes through weight loss. Cognitive improvements were accompanied by parallel improvements in endothelial and microvascular function.

Precision Exercise Medicine: Sex Specific Differences in Immune and CNS Responses to Physical Activity

Physical activity is a powerful lifestyle factor capable of improving cognitive function, modifying the risk for dementia associated with neurodegeneration and possibly slowing neurodegenerative disease progression in both men and women. However, men and women show differences in the biological responses to physical activity and in the vulnerabilities to the onset, progression and outcome of neurodegenerative diseases, prompting the question of whether sex-specific regulatory mechanisms might differentially modulate the benefits of exercise on the brain. Mechanistic studies aimed to better understand how physical activity improves brain health and function suggest that the brain responds to physical exercise by overall reducing neuroinflammation and increasing neuroplasticity. Here, we review the emerging literature considering sex-specific differences in the immune system response to exercise as a potential mechanism by which physical activity affects the brain. Although the literature addressing sex differences in this light is limited, the initial findings suggest a potential influence of biological sex in the brain benefits of exercise, and lay out a scientific foundation to support very much needed studies investigating the potential effects of sex-differences on exercise neurobiology. Considering biological sex and sex-differences in the neurobiological hallmarks of exercise will help to enhance our understanding of the mechanisms by which physical activity benefits the brain and also improve the development of treatments and interventions for diseases of the central nervous system.

Molecular and Brain Volume Changes Following Aerobic Exercise, Cognitive and Combined Training in Physically Inactive Healthy Late-Middle-Aged Adults: The Projecte Moviment Randomized Controlled Trial

Behavioral interventions have shown promising neuroprotective effects, but the cascade of molecular, brain and behavioral changes involved in these benefits remains poorly understood. Projecte Moviment is a 12-week (5 days per week—45 min per day) multi-domain, single-blind, proof-of-concept randomized controlled trial examining the cognitive effect and underlying mechanisms of an aerobic exercise (AE), computerized cognitive training (CCT) and a combined (COMB) groups compared to a waitlist control group. Adherence was > 80% for 82/109 participants recruited (62% female; age = 58.38 ± 5.47). In this study we report intervention-related changes in plasma biomarkers (BDNF, TNF-α, HGF, ICAM-1, SDF1-α) and structural-MRI (brain volume) and how they related to changes in physical activity and individual variables (age and sex) and their potential role as mediators in the cognitive changes. Our results show that although there were no significant changes in molecular biomarker concentrations in any intervention group, changes in ICAM-1 and SDF1-α were negatively associated with changes in physical activity outcomes in AE and COMB groups. Brain volume changes were found in the CCT showing a significant increase in precuneus volume. Sex moderated the brain volume change in the AE and COMB groups, suggesting that men may benefit more than women. Changes in molecular biomarkers and brain volumes did not significantly mediate the cognitive-related benefits found previously for any group. This study shows crucial initial molecular and brain volume changes related to lifestyle interventions at early stages and highlights the value of examining activity parameters, individual difference characteristics and using a multi-level analysis approach to address these questions.

Optimal dose and type of exercise to improve cognitive function in older adults: A systematic review and bayesian model-based network meta-analysis of RCTs

OBJECTIVE

To examine the dose-response relationship between overall and specific types of exercise with cognitive function in older adults.

DESIGN

Systematic Review and Bayesian Model-Based Network Meta-Analysis.

DATA SOURCES

Systematic search of MEDLINE, Web of Science, Scopus, PsycINFO and SPORTDiscus.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Randomized controlled trials of exercise interventions in participants aged 50 years or over, and that reported on at least one global cognition outcome.

RESULTS

The search returned 1998 records, of which 44 studies (4793 participants; 102 different effect sizes) were included in this review with meta-analysis. There was a non-linear, dose-response association between overall exercise and cognition. We found no minimal threshold for the beneficial effect of exercise on cognition. The estimated minimal exercise dose associated with clinically relevant changes in cognition was 724 METs-min per week, and doses beyond 1200 METs-min per week provided less clear benefits. We also found that the dose-response association was exercise type dependent, and our results show that clinically important effects may occur at lower doses for many types of exercise. Our findings also highlighted the superior effects of resistance exercises over other modalities.

CONCLUSIONS

If provided with the most potent modalities, older adults can get clinical meaningful benefits with lower doses than the WHO guidelines. Findings support the WHO recommendations to emphasise resistance training as a critical component of interventions for older adults.

Men and women show partly distinct effects of physical activity on brain integrity

Introduction

Physical inactivity and female sex are independently associated with increased Alzheimer's disease (AD) lifetime risk. This study investigates the possible interactions between sex and physical activity on neuroimaging biomarkers.

Methods

In 134 cognitively unimpaired older adults (≥65 years, 82 women) from the Age-Well randomized controlled trial (baseline data), we investigated the association between physical activity and multimodal neuroimaging (gray matter volume, glucose metabolism, perfusion, and amyloid burden), and how sex modulates these associations.

Results

The anterior cingulate cortex volume was independently associated with sex and physical activity. Sex and physical activity interacted on perfusion and amyloid deposition in medial parietal regions, such that physical activity was related to perfusion only in women, and to amyloid burden only in men.

Discussion

Physical activity has both sex-dependent and sex-independent associations with brain integrity. Our findings highlight partly distinct reserve mechanisms in men and women, which might in turn influence their risk of AD.

Highlights

Sex and physical activity have been linked to Alzheimer's disease (AD) progression.The association of sex and physical activity with brain health is partly independent.Different reserve mechanisms exist in men and women.

Leisure-Time and Non-Leisure-Time Physical Activities Are Dose-Dependently Associated With a Reduced Risk of Dementia in Community-Dwelling People Aged 40-74 Years: The Murakami Cohort Study

OBJECTIVE

Although physical activity (PA) in late life is considered a preventive factor for dementia, effects of different types of PAs on the development of dementia in early old age are unclear. This study aimed to determine the effect of leisure-time and non-leisure-time PAs on dementia risk in middle-aged and older adults during an 8-year follow-up.

DESIGN

Prospective cohort study.

SETTING AND PARTICIPANTS

Participants were 13,773 community-dwelling individuals aged 40-74 years who completed the baseline self-administered questionnaire survey of the Murakami cohort study in 2011-2013.

METHODS

Main predictors were leisure-time and non-leisure-time (commute, occupational work, and housework) PAs as assessed by MET score (MET-hour/d). The outcome was newly developed dementia determined using a long-term care insurance database. Covariates included demographics, lifestyle, body size, disease history, and PA level. Hazard ratios (HRs) were calculated using Cox proportional hazards models.

RESULTS

Mean age of participants was 59.0 (SD 9.3) years. Higher levels of leisure-time PA were associated with lower HRs (adjusted P for trend <.001), with all tertiles having significantly lower HRs (low: 0.71, 95% CI 0.51-0.99; medium: 0.59, 95% CI 0.43-0.81; high: 0.55, 95% CI 0.41-0.75) relative to the reference (zero). Higher quartiles of non-leisure-time PA were associated with lower adjusted HRs for dementia (adjusted P for trend < .001), with the second-fourth quartiles having significantly lower HRs (second: 0.73, 95% CI 0.54-0.98; third: 0.59, 95% CI 0.43-0.81; fourth: 0.55, 95% CI 0.41-0.75) relative to the lowest quartile. These associations were robust regardless of sex and age group.

CONCLUSIONS AND IMPLICATIONS

Both leisure-time and non-leisure-time PAs are independently and robustly associated with a reduced risk of dementia.

Depression and Increased Risk of Alzheimer's Dementia: Longitudinal Analyses of Modifiable Risk and Sex-Related Factors

OBJECTIVE

Our understanding of why older adults with depression are at increased risk of Alzheimer's disease (AD) remains incomplete. Most adults living with AD are women, and women have a near twofold lifetime risk of depression. We examined the risk of depression upon incident AD, and how sex influences this risk.

METHODS

Using the National Alzheimer's Coordinating Center database, older adults (age 50+) with normal cognition, who visited memory clinics across the United States between September 2005 and December 2019, were followed until first diagnosis of AD or loss to follow up. Multivariable survival analyses were performed to determine if recent and/or remote depression were independent risk factors for AD, if this depression-related risk exists for each sex or was moderated by sex.

RESULTS

Six hundred and fifty-two of 10,739 enrolled participants developed AD over a median follow-up of 55.3 months. Recent depression (active within the last 2 years) was independently associated with increased risk of AD (hazard ratio [HR] = 2.0; 95%CI, 1.5-2.6) while a remote history of depression was not (HR = 1.0; 95%CI, 0.7-1.5). After stratification by sex, recent depression was an independent predictor in females (HR = 2.3; 95%CI, 1.7-3.1) but not in males (HR = 1.4; 95%CI, 0.8-2.6). No interaction between recent depression and sex was observed.

CONCLUSION

Only a recent history of depression was associated with higher risk of AD. This association was significant among women only, but was not moderated by sex. Future analyses should determine if these findings extend to other populations and may be explained by variable distribution of neurobiological or other modifiable risk factors between the sexes.

Strenuous Exercise Habits and Spatial Mnemonic Discrimination Ability in Young Adult Men and Women

Increased physical activity has shown positive effects on various hippocampal memory functions through accumulating evidence that physical exercise and higher cardiorespiratory fitness can enhance human performance on nonspatial mnemonic discrimination tasks that rely on hippocampal pattern separation. However, there is less direct evidence of exercise effects on spatial pattern separation in humans, despite evidence for this association in rodent models. We examined the influence of strenuous exercise habits on spatial mnemonic discrimination among 176 young adults. We used a delayed match-/non-match-to-sample (same/different) task to assess pattern separation for spatial locations across varying degrees of similarity. Participants who reported regularly engaging in strenuous exercise three or more times per week performed significantly better than those who reported engaging in strenuous exercise fewer than three times per week, even when pattern separation tasks involved higher spatial similarity. These apparent exercise effects were observed for female, but not male, participants. These findings support likely benefits of strenuous exercise habits for human spatial pattern separation skills, and they suggest a need to explore potential interaction effects of exercise and gender.

Higher Handgrip Strength Is Linked to Better Cognitive Performance in Chinese Adults with Hypertension

OBJECTIVE

There is growing evidence that in adults, higher levels of handgrip strength (HGS) are linked to better cognitive performance. However, the relationship between HGS and cognitive performance has not been sufficiently investigated in special cohorts, such as individuals with hypertension who have an intrinsically higher risk of cognitive decline. Thus, the purpose of this study was to examine the relationship between HGS and cognitive performance in adults with hypertension using data from the Global Ageing and Adult Health Survey (SAGE).

METHODS

A total of 4486 Chinese adults with hypertension from the SAGE were included in this study. Absolute handgrip strength (aHGS in kilograms) was measured using a handheld electronic dynamometer, and cognitive performance was assessed in the domains of short-term memory, delayed memory, and language ability. Multiple linear regression models were fitted to examine the association between relative handgrip strength (rHGS; aHGS divided by body mass index) and measures of cognitive performance.

RESULTS

Overall, higher levels of rHGS were associated with higher scores in short-term memory (β = 0.20) and language (β = 0.63) compared with the lowest tertiles of rHGS. In male participants, higher HGS was associated with higher scores in short-term memory (β = 0.31), language (β = 0.64), and delayed memory (β = 0.22). There were no associations between rHGS and cognitive performance measures in females.

CONCLUSION

We observed that a higher level of rHGS was associated with better cognitive performance among hypertensive male individuals. Further studies are needed to investigate the neurobiological mechanisms, including sex-specific differences driving the relationship between measures of HGS and cognitive performance in individuals with hypertension.

Causes and Consequences of Interindividual Response Variability: A Call to Apply a More Rigorous Research Design in Acute Exercise-Cognition Studies

The different responses of humans to an apparently equivalent stimulus are called interindividual response variability. This phenomenon has gained more and more attention in research in recent years. The research field of exercise-cognition has also taken up this topic, as shown by a growing number of studies published in the past decade. In this perspective article, we aim to prompt the progress of this research field by (i) discussing the causes and consequences of interindividual variability, (ii) critically examining published studies that have investigated interindividual variability of neurocognitive outcome parameters in response to acute physical exercises, and (iii) providing recommendations for future studies, based on our critical examination. The provided recommendations, which advocate for a more rigorous study design, are intended to help researchers in the field to design studies allowing them to draw robust conclusions. This, in turn, is very likely to foster the development of this research field and the practical application of the findings.

Exercise and Fitness Neuroprotective Effects: Molecular, Brain Volume and Psychological Correlates and Their Mediating Role in Healthy Late-Middle-Aged Women and Men

Background: Although exercise is known to have a neuroprotective effect in aging, the mediators underlying the exercise-cognition association remain poorly understood. In this paper we aimed to study the molecular, brain, and behavioral changes related to physical activity and their potential role as mediators. Methods: We obtained demographic, physical activity outcomes [sportive physical activity and cardiorespiratory fitness (CRF)], plasma biomarkers (TNF-α, ICAM-1, HGF, SDF1-α, and BDNF), structural-MRI (brain volume areas), psychological and sleep health (mood, depressive and distress symptoms, and sleep quality), and multi-domain cognitive data from 115 adults aged 50-70 years. We conducted linear regression models and mediation analyses stratifying results by sex in a final sample of 104 individuals [65 women (age = 56.75 ± 4.96) and 39 men (age = 58.59 ± 5.86)]. Results: Women engaging in greater amounts of exercising showed lower TNF-α levels and greater dorsolateral prefrontal cortex and temporal lobe volumes. Men engaging in greater amounts of exercise showed greater temporal lobe volumes. CRF levels were not related to any of the analyzed outcomes in women but in men higher CRF was associated with lower TNF-α, HGF and ventricle volumes, greater volume of temporal and parietal lobes and fewer depressive symptoms and better mood. In men, reduced TNF-α and HGF levels mediated brain and cognitive CRF-related benefits. Conclusion: Our results show that exercise is a promising approach for influencing inflammation and brain volume and also contributes to ongoing discussions about the physiological mediators for the association between CRF and cognition in men.

Dietary Anti-Aging Polyphenols and Potential Mechanisms

For years, the consumption of a diet rich in fruits and vegetables has been considered healthy, increasing longevity, and decreasing morbidities. With the assistance of basic research investigating the potential mechanisms, it has become clear that the beneficial effects of plant-based foods are mainly due to the large amount of bioactive phenolic compounds contained. Indeed, substantial dietary intervention studies in humans have supported that the supplementation of polyphenols have various health-promoting effects, especially in the elderly population. In vitro examinations on the anti-aging mechanisms of polyphenols have been widely performed, using different types of natural and synthetic phenolic compounds. The aim of this review is to critically evaluate the experimental evidence demonstrating the beneficial effects of polyphenols on aging-related diseases. We highlight the potential anti-aging mechanisms of polyphenols, including antioxidant signaling, preventing cellular senescence, targeting microRNA, influencing NO bioavailability, and promoting mitochondrial function. While the trends on utilizing polyphenols in preventing aging-related disorders are getting growing attention, we suggest the exploration of the beneficial effects of the combination of multiple polyphenols or polyphenol-rich foods, as this would be more physiologically relevant to daily life.

Are gender differences in physical inactivity associated with the burden of dementia in low- and lower-middle income countries?

We explore the association between gender differences in physical inactivity and dementia in low and lower-middle-income countries (LLMIC). Data were extracted from the Repository of the Global Health Observatory and the United Nations Development Program with 2016 as reference year. Sample was composed using countries with a Human Development Index lower than 0.700. We calculated the population attributable fraction for physical inactivity in dementia. Absolute and relative gender differences in physical inactivity were calculated by subtracting and dividing the prevalence of physical inactivity among men from women's prevalence, respectively. Physical inactivity accounts for 12.25% cases of dementia in LLMIC. Women account for 58% of deaths and 56% of DALY's due to dementia in LLMIC. Adjusted prevalence of dementia was associated with prevalence and absolute gender difference in physical inactivity. DALYs and deaths due to dementia were associated with absolute and relative gender differences in physical inactivity. A reduction of 10% in physical inactivity only among women might reproduce a similar decline in the burden of dementia compared to the same 10% decrease in physical inactivity in the whole LLMIC population. Decreasing gender gap in physical inactivity may be an alternative approach to reduce the burden of dementia in LLMIC.