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Effects of resistance training exercise on cognitive performance in elderly individuals with memory impairment: Results of a controlled trial

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Objective: To detect the effects of a resistance training programon cognitive performance and muscle strength in sedentaryelderly individuals with memory impairment. Methods: Thirty-onesedentary elderly persons with no dementia or depression wererandomly distributed into two groups: Physical Activity Group andControl Group. The resistance training exercise program lastednine months and consisted of three series of six exercises persession, carried out on lever-type equipment for approximatelyone hour, twice a week. Every three months, both groups weresubmitted to the following cognitive tests: Rivermead BehavioralMemory Test (RBMT), Wechsler Adult Intelligence Scale (WAIS)Direct and Indirect Digit Span, Memory Complaints Scale, andCambridge Cognitive Test (CAMCOG). Results: After nine months,the group that did resistance exercises showed a significantincrease in the standardized RBMT score (p = 0.021) and in musclestrength (p < 0.001), with no significant difference in the otherparameters evaluated. Conclusions: These results indicate thatsupervised resistance exercises can improve memory performancein sedentary elderly individuals with prior memory compromise,besides increasing muscle strength.
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ORIGINAL ARTICLE
einstein. 2008; 6(4):402-7
Effects of resistance training exercise on cognitive
performance in elderly individuals with memory impairment:
results of a controlled trial
Efeitos dos exercícios resistidos no desempenho cognitivo de idosos com comprometimento
da memória: resultados de um estudo controlado
Alexandre Leopold Busse1, Wilson Jacob Filho2, Regina Miskian Magaldi3, Venceslau Antônio Coelho4,
Antônio César Melo5, Rosana Aparecida Betoni6, José Maria Santarém7
ABSTRACT
Objective: To detect the effects of a resistance training program
on cognitive performance and muscle strength in sedentary
elderly individuals with memory impairment. Methods: Thirty-one
sedentary elderly persons with no dementia or depression were
randomly distributed into two groups: Physical Activity Group and
Control Group. The resistance training exercise program lasted
nine months and consisted of three series of six exercises per
session, carried out on lever-type equipment for approximately
one hour, twice a week. Every three months, both groups were
submitted to the following cognitive tests: Rivermead Behavioral
Memory Test (RBMT), Wechsler Adult Intelligence Scale (WAIS)
Direct and Indirect Digit Span, Memory Complaints Scale, and
Cambridge Cognitive Test (CAMCOG). Results: After nine months,
the group that did resistance exercises showed a significant
increase in the standardized RBMT score (p = 0.021) and in muscle
strength (p < 0.001), with no significant difference in the other
parameters evaluated. Conclusions: These results indicate that
supervised resistance exercises can improve memory performance
in sedentary elderly individuals with prior memory compromise,
besides increasing muscle strength.
Keywords: Aging; Health of the elderly; Dementia; Cognition
disorders; Motor activity
RESUMO
Objetivo: Detectar os efeitos de um programa de exercícios
resistidos no desempenho cognitivo e na força muscular de idosos
sedentários com comprometimento da memória. Métodos: Trinta e
um idosos sedentários sem demência ou depressão foram distribuídos
aleatoriamente em dois grupos: Grupo Atividade Física e Grupo Controle.
O programa de exercícios resistidos durou nove meses e consistiu de
três séries de seis exercícios por sessão, realizados em aparelhos com
sistema de alavancas, por aproximadamente uma hora, duas vezes
por semana. Ambos os grupos foram submetidos aos seguintes testes
cognitivos a cada três meses: Teste Comportamental de Memória
de Rivermead (RBMT), Amplitude de Dígitos Diretos e Indiretos
do Wechsler Adult Intelligence Scale (WAIS), Escala de Queixas de
Memória e Teste Cognitivo de Cambridge (CAMCOG). Resultados:
Após nove meses, o grupo que realizou os exercícios resistidos teve um
aumento significativo do escore padronizado do RBMT (p = 0,021) e
da força muscular (p < 0,001), sem diferença significativa dos demais
parâmetros avaliados. Conclusões: Estes resultados indicam que os
exercícios resistidos supervisionados podem melhorar o desempenho
da memória em idosos sedentários com prévio comprometimento,
além de determinar o aumento da força muscular.
Descritores: Envelhecimento; Saúde do idoso; Demência; Transtornos
cognitivos; Atividade motora
Study carried out at the Geriatric Service of Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo – HC-FMUSP – São Paulo (SP), Brazil.
1 PhD; Assistant Physician at Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo – HC-FMUSP, São Paulo (SP), Brazil.
2 Full Professor of Geriatrics at Faculdade de Medicina of Universidade de São Paulo – FMUSP, São Paulo (SP), Brazil.
3 Assistant physician of the Department of Geriatrics at Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo – HC-FMUSP, São Paulo (SP), Brazil.
4 Assistant physician of the Department of Geriatrics at Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo – HC-FMUSP, São Paulo (SP), Brazil.
5 Physical education professional of Centro de Estudos em Ciências da Atividade Física (CECAFI) of Geriatrics at Faculdade de Medicina of Universidade de São Paulo – HC-FMUSP, São Paulo (SP), Brazil.
6 Physical education professional of Centro de Estudos em Ciências da Atividade Física (CECAFI) of Geriatrics at Faculdade de Medicina of Universidade of São Paulo – HC-FMUSP, São Paulo (SP), Brazil.
7 PhD; Coordinator of Centro de Estudos em Ciências da Atividade Física da Disciplina (CECAFI) of Geriatrics at Faculdade de Medicina of Universidade de São Paulo – HC-FMUSP, São Paulo (SP), Brazil.
Corresponding author: Alexandre Leopold Busse – Avenida Angélica, 1.761 – conj. 114 – Higienópolis – CEP 01239-020 – São Paulo (SP), Brasil – Tel.: 11 3214-2953 – e-mail: alebusse@gmail.com
Received on: May 28, 2008 – Accepted on: Oct 30, 2008
einstein. 2008; 6(4):402-7
Effects of resistance training exercise on cognitive performance in elderly individuals with memory impairment: results of a controlled trial 403
INTRODUCTION
Aging of the population is a worldwide phenomenon
that has been increasing due to a marked decrease in
fecundity and increase in life expectancy(1-2). One of the
consequences of this is the increase in prevalence of
dementia that is clinically characterized by a compromise
in fixation or evocation memory and impairment of at
least one other cognitive dominion (language, praxis,
and executive functions)(3).
However, the complaint of memory difficulty is one of
the most frequent in the elderly. One study performed in a
metropolitan Brazilian region demonstrated that 54% of
elderly individuals interviewed had memory complaints(4).
There are medications that can be beneficial in cases of
dementia, but there was no benefit in elderly subjects
who presented only with memory impairment(5-6).
Therefore, memory rehabilitation by non-
pharmacological means has been intensely sought.
Recently, a correlation between the preservation or
even improvement of cognitive performance and
physical exercises, especially aerobic exercises, has
been particularly researched. A systematic review
which included 18 longitudinal studies (1966 to
2001) concluded that aerobic exercises may provide
a consistent advantage in cognitive performance of
sedentary elderly individuals(7). Another systematic
review including 30 studies (1970 to 2003) demonstrated
a decrease in occurrence of dementia(8).
One particular type of physical exercise has shown
great benefit in the elderly: strength training, also called
resistance exercises(9). Nevertheless, the effects of these
on cognition have not been studied very often.
OBJETIVE
Therefore, the objectives of this study were to
evaluate the effects of a supervised resistance exercise
program on cognition in sedentary elderly subjects with
memory impairment; to compare the performance of
the subjects in cognition tests and the progression of
muscle strength as to gender.
METHODS
The study was conducted at the Memory of the Elderly
Outpatient´s Clinic (AMI) of the Geriatric Service
of Hospital das Clínicas of Faculdade de Medicina da
Universidade de São Paulo (HC-FMUSP), site for patient
selection, clinical follow-up and cognitive assessments.
Inclusion criteria were: elderly of both genders
aged 60 years or more who had not performed
programmed physical exercises in the six-month
period prior to the selection process; subjective
memory complaints reported by the patient or by
an informant; geriatric depression scale (GDS)(10)
within normal limits; mini-mental state examination
(MMSE)(11) within limits of normal corrected by
schooling(12); changes in the objective memory test: a
screening Rivermead test score equal to or less than
nine(13); preserved function in instrumental and basic
activities of daily life(14-15).
Exclusion criteria were: dementia, depression and
anxiety disorders as per Diagnostic and Statistical
Manual of Mental Disorders of the American
Psychiatric Association (DSM IV) criteria(3);
head trauma or stroke in the previous year; recent
use of substances that contribute to memory loss
(alcohol, antidepressants, anxiolytics, neuroleptics,
anticonvulsants, hypnotics, opioid analgesics);
alterations in laboratory tests (glucose, hepatic
transaminases, thyroid hormones, creatinine, urea,
sodium, potassium, calcium, erythrocyte sedimentation
rate, serology for syphilis, levels of vitamin B12 and
folic acid), and unstable cardiovascular disease.
Once the selection criteria were met, patients
signed an informed consent form approved by the
Commission for Research Project Analysis (CAPPesq)
of HC-FMUSP and names were drawn by a person
independent of the research using papers taken from
an opaque envelope, with two possibilities: Intervention
Group or Control Group. Both groups were evaluated
as per a cognitive assessment protocol at baseline, and
after three, six, and nine months(13).
Cognitive assessment
Cambridge cognitive test (CAMCOG) is a cognitive
test (with 67 items) that evaluates orientation,
language, memory, praxis, attention, abstract
thinking, perception, and calculation. The score
varies from 0 to 107(16-17).
Rivermead Behavioral Memory Test (RBMT) is a
memory test consisting of a battery of practical tasks
which seeks to simulate daily situations, in order to
decrease the interference of cultural factors. The
standardized score varies from 0 to 24 and screening
scores vary from 0 to 12(13).
Direct and Indirect Digit Span of the Wechsler Adult
Intelligence Scale (WAIS) measures the capacity for
concentration and working memory, respectively. It
consists of a repetition of a sequence of numbers
and both scores vary from 0 to 14(18).
Memory Complaints Scale (MCS) is a questionnaire
derived from “The Cambridge examination for
mental disorders of the elderly” (CAMDEX) and
was designed so that the greater the number of
complaints, and the greater their interference in the
einstein. 2008; 6(4):402-7
404 Busse AL, Filho WJ, Magaldi RM, Coelho VA, Melo ac, Betoni RA, Santarém JM
subject’s life, the greater the score that varies from 0
to 21 is(19).
Statistical analysis
In order to compare the means of the groups, the
t-Student test was used for continuous variables. In
categorical variables, χ2 test or proportion analysis of
two samples was used, and, in reduced samples, the
Fischer’s exact test was applied. To analyze the effect
of group and time and the effect of group and gender
regarding the results of the cognitive tests, the analysis of
variance (ANOVA) was used for repeat measurements.
A value of α < 0.05 was adopted, and the analysis was
carried out using the MINITAB 14 statistics program.
Intervention
The resistance exercises were performed at the
Experimental Therapeutic Gymnasium as per the
training protocol used by Centro de Estudos em Ciências
da Atividade Física (CECAFI) of the Department of
Geriatrics of FMUSP. The protocol carried out at the
CECAFI was based on scientific evidence on the use of
resistance exercises with safety and efficacy to increase
muscle strength in the elderly(9).
The program consisted of six exercises per training
session, lasting for approximately one hour each time,
twice a week. In each exercise, loads were progressively
increased in series of 12, 10, and 8 repetitions. Each
repetition was made slowly, with approximately three
seconds during the concentric contraction phase and six
seconds in the eccentric contraction phase. The series
of eight repetitions was performed with the highest
load, which was increased in subsequent sessions by
the supervising physical therapist or physical education
professional, always attentive to not allowing a tendency
towards isometry in apnea.
As cardiovascular safety measures, arterial blood
pressure was measured before and after the sessions,
with a resting period of one to two minutes between
the series, avoiding maximal muscle contraction in
apnea during the repetitions. The protocol was directed
towards training of the large muscle groups (chest press,
rowing, leg press, calves, abdominal, and lumbar). The
exercises were carried out on six equipment pieces with
system of levers and weights (Biodelta Maxiflex line)
RESULTS
Subject characteristics
Thirty-one elderly individuals were selected (8 men and
23 women) and distributed by drawing of names: 17 to
the Resistance Training Group and 14 to the Control
Group. The mean age among the participants was 72.2
± 5.4 years (varying from 62 to 86 years). There was
no statistical difference in the means of age, level of
schooling, and chronic diseases between the groups.
A statistical difference was identified (p = 0.049) as to
gender between the groups. Four participants, two from
the Resistance Exercise Group and two from the Control
Group abandoned the study before its conclusion, but
all data obtained during follow-up of these individuals
were included in the statistical analysis. The subject
characteristics in the initial phase are presented in
Table 1.
Variables
Control
Group
(n = 17)
Physical
Activity Group
(n = 14)
p value
Age: mean ± sd (years) 73.3 (± 6.4) 70.4 (± 3.6) 0.13*
Women/men 15 / 2 8 / 6 0.049**
Schooling: mean ± sd (years) 4. 3 (± 4.6) 6. 3 (± 3.8) 0.24*
CAMCOG: mean ± sd 81.3 (± 8.1) 82.9 (± 8.9) 0.62*
Rivermead test: mean ± sd 16.1 (± 3.2) 15.5 (± 3.2) 0.61*
Arterial hypertension 10 (58.8%) 7 (50%) 0.78***
Diabetes mellitus 3 (17.6%) 4 (28.6%) 0.66**
Coronary artery disease 1 (5.9%) 1 (7.1%) 1.0**
Arterial fibrillation 1 (5.9%) 1 (7.1%) 1.0**
Dyslipidemia 5 (29.4%) 7 (50%) 0.16***
Stroke 1 (5.9%) 0 (0%) 1.0**
Hypoacusis 1 (5.9%) 1 (7.1%) 1.0**
Osteoporosis 4 (23.5%) 2 (14.3%) 0.67**
Table 1. Baseline sample characteristics
* t-Student test; ** Fisher’s exact test; *** proportion analysis of two samples
Cognition results
The results of the cognitive assessment may be evaluated
by data in Table 2. The physical activity group showed
an increase with statistical significance in the RBMT
mean detected during the fourth assessment, after nine
months of resistance training (Figure 1). An effect of
interaction between the group and time was detected
(p = 0.021). The initial means in both genders are
not the same (p = 0.003), since the mean in males is
greater than that in females, regardless of the group. In
the Physical Activity Group (PA), men showed a mean
variation (final minus initial values) of 0.8 (95%CI=
-2.1-3.7), and for women it was 4.7 (95%CI = 2.3-7.1).
In the Control Group, men showed a mean variation
of -4 (95%CI = -8.6-0.6) and women of -0.2 (95%CI
= -2.0-1.6). Thus, the mean variation in RBMT also
depends on the gender (p = 0.045), since the variation
in the women of AF was greater than in the men.
einstein. 2008; 6(4):402-7
Effects of resistance training exercise on cognitive performance in elderly individuals with memory impairment: results of a controlled trial 405
The CAMCOG means increased significantly in
both groups over the course of the study (p < 0.001),
but there was no difference with statistical significance
between the groups. No group effect was identified at
any of the timepoints (p= 0.322). In other words, the
means coincided, but at the end they were greater than
in the beginning, both in group physical activity and
in Control Group. No interaction effect was detected
between time and gender in the CAMCOG mean
(p = 0.71).
Muscle strength results
With the objective of estimating the variation in muscle
strength of the resistance training participants, the
means of the loads used in the series of eight repetitions
were compared, as of the end of the first month for
adaptation. There was an increase with statistical
significance in the means of the loads (Table 3). No
interaction effect was detected between gender and
progression of muscle strength by the Kruskal-Wallis
test: rowing (p = 0.16); leg press (p = 0.45); lumbar
extension (p = 0.80); abdominal (p = 0.25); pectoral
(p = 0.06), and calves (p = 0.74).
Figure 1. Mean variation (± sd) in the Physical Activity Group (PA) and in the
Control group (C) in the Rivermead test during the nine-month period of study
(p= 0.021)
Group
9630
CPACPACPACPA
20
19
18
17
16
15
14
PA
C
Group
Month
Rivermead test
Cognitive assessment Baseline 3rd
month
6th
month
9th
month p value*
CAMCOG (C) 81.3 82.1 83.4 84.5 0.32
CAMCOG (PA) 82.9 84.4 88.1 89.2
Rivermead test (C) 16.1 16.7 14.9 15.33 0.021
Rivermead test (PA) 15 17.1 17.6 18.9
MCS (C) 7.6 7.5 8.1 8.2 0.36
MCS (PA) 8.9 8.9 8.7 8.2
Direct digit span (C) 4.6 4.6 4.5 4.9 0.66
Direct digit span (PA) 4.9 4.5 4.6 4.6
Indirect digit span (C) 4.2 3.8 4.3 4.2 0.13
Indirect digit span (PA) 3.7 4 4.2 4.5
Table 2. Results of cognitive assessment in both groups
C = Control Group; PA = Physical Activity Group; *analysis of variance (group/time); MCS = memory complaint scale
Exercises 1st month 3rd month 6th month 9th month p*
Lumbar
extension
13.2 ± 7.94 27.5 ± 21.1 37.1 ± 22.8 47.1 ± 24.1 p < 0.001
Leg press 16.1 ± 8.94 25.4 ± 19.56 37.3 ± 24.39 45 ± 23.4 p < 0.001
Calves 10.3 ± 5.4 17.8 ± 15.6 22 ± 17.6 28.13 ± 20.9 p = 0.004
Rowing 10.1 ± 7.9 16.9 ± 7.6 20.4 ± 6.8 26.59 ± 11.7 p = 0.001
Abdominal 9.7 ± 5.2 15.3 ± 12.1 19 ± 13.1 22.7 ± 10.2 p = 0.001
Pectoral 5 ± 4 10.4 ± 9.1 11.7 ± 2.7 13.3 ± 2.8 p = 0.001
Table 3. Progression of mean (± sd) resistance training load (kg)
*Analysis of variance (ANOVA)
DISCUSSION
Even though the evidence that aerobic exercise benefits
cognition in the elderly is consistent, few studies have
been conducted to assess the effect of resistance
exercises on the cognition of elderly individuals. The
study by Perrig-Chiello et al.(20) was the first with this
purpose, but it only demonstrated an improvement in
general well-being.
In the present study, the RBMT mean increased
significantly in the Intervention Group in comparison
with the Control Group. We point out that RBMT was
developed to measure memory loss and monitor the
effects of rehabilitation. It is not affected by level of
schooling, age, or gender, and since it is a behavioral
test, it shows a good correlation with memory
difficulties in situations of daily life. However, there
was no statistically significant difference between the
means of the Memory Complaints Scale (MCS) of
both groups.
In the study performed by Lachman et al.(21), with
210 elderly subjects, there was an improvement in
working memory only in the subgroup with the greatest
progression of loads during training. In the study by
Cassilhas et al.(22), with 62 elderly individuals, there was
a significant improvement, both in working memory
and episodic memory. However, in these two studies,
with six-month duration, there was no selection of the
elderly according to memory complaints or by prior
performance on cognitive tests.
In this study, in the PA, there was improved
performance on the RBMT in both genders, but the
improvement in females was significantly superior. In
some prior studies it had been observed that the female
gender showed superior benefits than the male gender,
especially with aerobic exercises. Nevertheless, it still
is not clear by which mechanisms gender influences
the modulation of the effects of physical exercises on
cognition(23).
einstein. 2008; 6(4):402-7
406 Busse AL, Filho WJ, Magaldi RM, Coelho VA, Melo ac, Betoni RA, Santarém JM
The significant increase in CAMCOG, both in
the Control Group and the Intervention roup can be
explained by the test learning effect, since there is only
one version applied every three months. The learning
effect did not occur with the RBMT, possibly because
there are four versions of it and a different version was
used at each assessment. Performance on CAMCOG
was statistically the same for both genders.
There was no statistically significant difference
between the means of the direct and indirect digit span
in both groups. Therefore, this is different from the
study performed by Lachman et al.(21) and the study by
Cassilhas et al.(22), in which a significant improvement
was noted in these tests.
Muscle strength was measured indirectly, i.e., by
progression of loads in the resistance training program.
There was a significant increase in loads in the six-piece
equipment used, between the end of the first month and
the end of the ninth month of training, which was similar
in both genders. The mean increase estimated in muscle
strength was 178%, similar to the results obtained in
studies carried out in our region with a similar exercise
protocol(24-25).
Increased sociability is, no doubt, one of the
objectives of the prescription of physical exercises
to promote health for any age bracket. It is possible,
then, that the greater social interaction afforded by the
practice of resistance exercises contributed towards an
improved performance in memory in the Intervention
Group. However, it has been noted in various studies
that the greater the intensity of the exercise, the
better the progression of cognitive performance,
demonstrating that increased sociability, in itself, is
not sufficient(26).
This study presents relevant contributions to
scientific knowledge, but there are some limitations
that may be adjusted in future research projects.
The number of participants was small, which led
to a significant difference in distribution of the
genders between the groups during the random
distribution. A more expressive sample size would
certainly lend greater reliability to the results found,
and would eventually show other benefits that were
not significant in this study. The results of cognitive
assessment could also be more reliable if the raters
had no prior knowledge of which group the subjects
belonged to.
CONCLUSIONS
The results indicate that nine months of supervised
resistance exercises may be effective in improving the
memory performance of sedentary individuals with
memory impairment. In the Intervention Group, there
was a significant improvement in performance of the
RBMT in both genders, but the improvement in the
female gender was more expressive. The CAMCOG
may be affected by learning the test if it is applied
repeatedly, with intervals of three months. The increase
in muscle strength in the Intervention Group was very
significant in all muscle groups covered in the resistance
exercise protocol. There was no difference in proportion
of muscle gain between genders.
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... One of the four articles reported the same results as the other three and was removed because of its smaller sample size [38], and another article was excluded because it reported only changes from the baseline [39]. One article was removed due to the absence of standard deviation data and an inability to obtain the original data from the author [40]. Ultimately, seven studies were included in the analysis, all having a pre-test and a post-test [24,[27][28][29][30][31][32]. ...
... After subgroup analysis, it appears that different durations per session of training may explain some of the remaining heterogeneity. Consistent with our study, two other studies suggest that progressive resistance training significantly improves general cognitive function in MCI patients [40,42]. However, a previous systematic review of older adults reported that resistance training can improve general cognitive function and that triweekly resistance training has a better effect [26]. ...
... Negligible heterogeneity was found in working memory. Regrettably, two high-quality studies were excluded because only changes from the baseline were reported [39,40], but their conclusions based on changes from the baseline were consistent with this study. Within the limited research, one study investigated the relationship between resistance training and working memory in healthy adults and found no evidence of benefit, which is consistent with this study [48]. ...
Article
This study investigated the benefits of resistance training on cognition in patients with mild cognitive impairment. We searched the PubMed, Embase and Cochrane Library databases, and seven randomized controlled trials were reviewed. We evaluated the risk of bias using the Cochrane Collaboration’s bias assessment tool. Standard mean differences with 95% confidence intervals were calculated for statistical analysis. This meta-analysis assessed three variables: general cognitive function, executive function and working memory. The results indicate that general cognitive function improved significantly (standardized mean difference: 0.53, P=0.04), and further subgroup analyses on frequency and duration per session showed that the subgroups ‘twice a week’ (P=0.01) and ‘duration per session >60 min’ (P=0.0006) exhibited better performance than the subgroups ‘three time a week’ (P=0.47) and ‘duration per session <60 min’ (P=0.53). Additionally, a moderate effect size was found in executive function (standardized mean difference: 0.50, P=0.0003), and there was non-significant effect in working memory (P=0.14). In summary, resistance training may mitigate mild cognitive impairment by improving cognition. Larger-scale studies are recommended to demonstrate the relationship between resistance training and cognition in mild cognitive impairment.
... After the discovery of the powerful effects of ET on brain neurogenesis and plasticity, many studies tested ET as a rescue strategy for mild cognitive impairment (MCI, an intermediate condition between healthy ageing and dementia that is often predictive of future AD development), dementia and AD in humans and in animal models. While a recent metanalysis in humans reported that there is strong evidence that greater amounts of ET (3-5 times per week) are associated with a reduced risk of developing cognitive impairment, including AD (Erickson et al., 2019), there are also studies reporting variable or null effects of ET on cognition in healthy, MCI and AD subjects (Busse et al., 2008;Hassmén and Koivula, 1997;Kimura et al., 2010;Kramer et al., 2001;Langlois et al., 2013;Legault et al., 2011;Scherder et al., 2005; for metanalyses see Gates et al., 2013;Ströhle et al., 2015;Young et al., 2015). ...
... A deep analysis of most of the randomized clinical trials (RCTs), included those in which it is concluded that there is low evidence of beneficial effects, show that at intense (at least two times per week) ET (preferable aerobic or coordinative), lasting for more than 6 months, the cognitive performance is improved in at least one of the neuropsychological task administered (usually executive function and memory) and/ or in daily life activity (Baker et al., 2010;Brown et al., 2009;Kramer et al., 2001;Lam et al., 2015Lam et al., , 2012Muscari et al., 2010;Sink et al., 2015;Thomas et al., 2020;Van Uffelen et al., 2008a, 2008b. Shorter training and/or non-aerobic exercise generally are ineffective (Busse et al., 2008;Kimura et al., 2010;Legault et al., 2011;Scherder et al., 2005). ...
Article
Women are more prone than men to develop age-related dementia, such as Alzheimer’ disease (AD). This has been linked to the marked decrease in circulating estrogens during menopause. This review proposes to change this perspective and consider women’s vulnerability to developing AD as a consequence of sex differences in the neurobiology of memory, focusing on the hippocampus. The hippocampus of cognitively impaired subjects tends to shrink with age; however, in many cases, this can be prevented by exercise or cognitive training, suggesting that if you do not use the hippocampus you lose it. We will review the developmental trajectory of sex steroids-regulated differences on the hippocampus, proposing that the overall shaping action of sex-steroids results in a lower usage of the hippocampus in females, which in turn makes them more vulnerable to the effects of ageing, the “network fragility hypothesis”. To explain why women rely less on hippocampus-dependent strategies, we propose a “computational hypothesis” that is based on experimental evidence suggesting that the direct effects of estrogens on hippocampal synaptic and structural plasticity during the estrous-cycle confers instability to the memory-dependent hippocampal network. Finally, we propose to counteract AD with training and/or treatments, such as orienteering, which specifically favour the use of the hippocampus.
... This finding was supported by a later study that investigated the effects of RT on cognitive performance and muscle strength in sedentary older adults with subjective memory complaints. 93 It was found that the exercise group, particularly the women, demonstrated improved memory performance within the cognitive battery administered and increased muscle strength compared to the control group. This finding indicates that RT may improve memory deficits in elderly participants with memory complaints. ...
... The cognitive improvements observed by Busse et al. 93 were more evident in females than males and Xu et al. 89 reported that sex differences could account for differences in improvements of cerebral perfusion and cognition induced by RT. Two larger trials examined this finding by investigating the efficacy of chronic exercise training, particularly RT, on executive functions and cognition in elderly females with MCI. ...
Article
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Derangements in cerebrovascular structure and function can impair cognitive performance throughout ageing and in cardiometabolic disease states, thus increasing dementia risk. Modifiable lifestyle factors that cause a decline in cardiometabolic health, such as physical inactivity, exacerbate these changes beyond those that are associated with normal ageing. The purpose of this review was to examine cerebrovascular, cognitive and neuroanatomical adaptations to ageing and the potential benefits of exercise training on these outcomes in adults 50 years or older. We systematically searched for cross-sectional or intervention studies that included exercise (aerobic, resistance or multimodal) and its effect on cerebrovascular function, cognition and neuroanatomical adaptations in this age demographic. The included studies were tabulated and described narratively. Aerobic exercise training was the predominant focus of the studies identified; there were limited studies exploring the effects of resistance exercise training and multimodal training on cerebrovascular function and cognition. Collectively, the evidence indicated that exercise can improve cerebrovascular function, cognition and neuroplasticity through areas of the brain associated with executive function and memory in adults 50 years or older, irrespective of their health status. However, more research is required to ascertain the mechanisms of action.
... The results in this portion of the study are in line with the previous studies (Peig-Chiello et al., 1998;Lachman et al., 2006;Cassilhas et al., 2007;Busse et al., 2008;Bherer et al., 2013) reported that resistance exercise has shown improvement in children cognition. Thus, resistance exercise showed improvements in short term memory and working memory performance (Busse et al., 2008); total memory (Lachman et al., 2006); comparative reasoning and memory (Cassilhas et al., 2007); information processing speed, attention and memory (Chang et al., 2012). ...
... The results in this portion of the study are in line with the previous studies (Peig-Chiello et al., 1998;Lachman et al., 2006;Cassilhas et al., 2007;Busse et al., 2008;Bherer et al., 2013) reported that resistance exercise has shown improvement in children cognition. Thus, resistance exercise showed improvements in short term memory and working memory performance (Busse et al., 2008); total memory (Lachman et al., 2006); comparative reasoning and memory (Cassilhas et al., 2007); information processing speed, attention and memory (Chang et al., 2012). ...
... It seems that there are different ways which will decrease brain's aging speed and memory at older ages, one of which is doing continuous exercises and physical activities. The conducted researches on humans and animals have shown that exercise will postpone aging process and increase life time (Busse, 2008), improve brain function (including increased synaptic plasticity, learning and memory) , increase hippocampus' electrical activities (due to changing activity of neuron and neurotransmitter) (Fordyce et al., 1993) and help to cure diseases caused by aging (Gillespie, et al., 2001). Thus, regular physical activities are one of the most important factors for maintaining body and mental health among the elderly so that these activities have been developed by a group of experts from more than 150 national organizations in the USA as one of 15 priorities for behavior changing in order to achieve health (Cromwell et al., 2007). ...
Article
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The objective of present research was to study effect of eight weeks of walking and exercising in water with different intensities on memory of elderly men. The population included 60 to 75 year old men who were living in Kahrizak Charity Foundation, out of whom 50 people were selected as the research sample. To implement the intervention, two training protocols of walking and exercising in water with low (30-40%) and moderate (40-60%) intensities were used in eighteen 45-min sessions. Personal information questionnaire and Wexler Memory Test were also used for matching and selecting the participants in the research groups; after the training intervention, Wexler Memory Test was re-used for studying memory condition of the participants. Two-way covariance analysis method was applied while analyzing the data (p≤0.05). In this method, training type and intensity were considered the first and second factors, respectively. All the statistical analyses of this study were done in SPSS 16. Moreover, age was considered the covariance variable to control for the participants' age. Results of two-way covariance showed that walking and exercising in water had a positive effect on memory of elderly men while training intensity did not have any significant effect on their memory. Bonfori post-hoc test demonstrated no significant difference between various types of training intensity in each type of exercise and no significant difference was observed between different types of aerobic exercises with special intensity. Generally, these results showed that aerobic exercises had a significantly positive effect on memory of elderly men, which may be independent from type and intensity of aerobic activities.
... Additionally, an RCT conducted by de Oliveira Silva and colleagues found that an exercise intervention improved mobility and executive function in those with MCI, but not those with AD dementia, suggesting that exercise interventions may be more effective when implemented earlier in disease progression [93]. Resistance training interventions have also been associated with improved attention [65] and executive function [65,94] in cognitively normal older adults, and improved attention [82], memory [82,95], and global cognitive function [96,97] in individuals with MCI. ...
Article
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A decade has passed since we published a comprehensive review in this journal addressing the topic of promoting successful cognitive aging, making this a good time to take stock of the field. Because there have been limited large-scale, randomized controlled trials, especially following individuals from middle age to late life, some experts have questioned whether recommendations can be legitimately offered about reducing the risk of cognitive decline and dementia. Despite uncertainties, clinicians often need to at least make provisional recommendations to patients based on the highest quality data available. Converging lines of evidence from epidemiological/cohort studies, animal/basic science studies, human proof-of-concept studies, and human intervention studies can provide guidance, highlighting strategies for enhancing cognitive reserve and preventing loss of cognitive capacity. Many of the suggestions made in 2010 have been supported by additional research. Importantly, there is a growing consensus among major health organizations about recommendations to mitigate cognitive decline and promote healthy cognitive aging. Regular physical activity and treatment of cardiovascular risk factors have been supported by all of these organizations. Most organizations have also embraced cognitively stimulating activities, a heart-healthy diet, smoking cessation, and countering metabolic syndrome. Other behaviors like regular social engagement, limiting alcohol use, stress management, getting adequate sleep, avoiding anticholinergic medications, addressing sensory deficits, and protecting the brain against physical and toxic damage also have been endorsed, although less consistently. In this update, we review the evidence for each of these recommendations and offer practical advice about behavior-change techniques to help patients adopt brain-healthy behaviors.
... Several studies found emerging evidence for the improvement in cognitive abilities and positive restructuring of the brain by resistance training Busse et al., 2008;Liu-Ambrose et al., 2012;Nourhashémi et al., 2002). Lower muscle strength was associated with higher risk of AD (Boyle et al., 2009). ...
Article
Mild cognitive impairment (MCI) is defined as an intermediate state between normal cognitive aging and dementia. It describes a status of the subjective impression of cognitive decline and objectively detectible memory impairment beyond normal age-related changes. Activities of daily living are not affected. As the population ages, there is a growing need for early, proactive programs that can delay the consequences of dementia and improve the well-being of people with MCI and their caregivers. Various forms and approaches of intervention for older people with MCI have been suggested to delay cognitive decline. Pharmacological as well as non-pharmacological approaches (cognitive, physiological, nutritional supplementation, electric stimulation, psychosocial therapeutic) and multicomponent interventions have been proposed. Interventional approaches in MCI from 2009 to April 2019 concerning the cognitive performance are presented in this review.
... Prior researches found the effects on memory of both aerobic and resistance exercise in young individuals. While such an effect was also found in elderly individuals with resistance training exercise (Busse et al. 2008;Pasqualina et al. 1998). Regarding the population, consistent with the elderly individuals, the MA patients have declined memory ability comparing with healthy individuals. ...
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Exercise interventions have been considered to be an effective treatment for drug addiction. However, there is little dirct evidence that exercise affects brain activity in individuals afftected by drug addiction. Therefore, the aim of the present study was to investigate the effects of different exercise programs on detoxification. Cognitive recovery with 64-channel electroencephalography (EEG) recordings was obtained before and after three months of daily aerobic and anaerobic exercise. A total of 63 subjects with methamphetamine addiction were recruited and randomly divided into three groups for cognitive study in four behavioral states: an anaerobic resistance treatment group, an aerobic cycling treatment group and a control group. In addition, four behavioral states were examined: eyes-closed and eyes-open resting states, and exploratory behavior states following either drug- or neutral-cue exposure. Over a 12-week period,the alpha block ratio in the control group showed a slight decrease, while clear increases were observed in the resistance exercise and cycling treatment groups, particularly under the frontal and temporal regions in the eyes-open and drug-cue conditions. The major EEG activity frequency in the resistance treatment group during the drug-cue behavior task decreased compared with the frequencies of the cycling exercise and control groups. Meanwhile, the power of higher brain rhythms in the resistance treatment group was increased. Finally, the brain alpha wave left-lateralization index from EEG recording sites, F1–F2, in the resistance and cycling treatment groups under the eyes-closed condition positively decreased, while the control groups only showed slight decreases. Taken together, these results suggest that different types of exercise may induce distince and different positive therapeutic effects to facilitate detoxification.
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Introduction and purpose: Physical inactivity in the elderly is an important risk factor for the development of cognitive impairment and Alzheimer’s disease. This study aimed to investigate the effect of Aerobics, ware aerobic exercise, and water-based exercise training on working memory of elderly women diagnosed with Alzheimer's disease. Materials and Methods: This was a quasi-experimental study with three groups' pre-test post-test design. The participants, 30 elderly women diagnosed with Alzheimer's disease, with the mean age of 64 years were randomly assigned into three groups (aerobic, water aerobic exercise, and water-based exercise training). The training protocol consisted of 18 sessions, and each session lasted 45 minutes. The Wechsler Memory Scale (WMS) was used to measure the memory and the N-Back software was used to assess the working memory of the study participants. Data were analyzed using the SPSS software version22. Two-way repeated measurement ANOVA (3 group × 2 times) and paired sample t-test were used to analyze the data. Findings: After the training, participants in all groups had better working memory status. However, the participants in the water aerobic exercise group showed greater improvement in working memory compares to other groups. There were significant differences between the three groups in the three subscales of visual memory, associated learning, and memory span. Conclusion: The result of this study indicated that water aerobic exercise can effectively improve the cognitive function of elderly women diagnosed with Alzheimer’s disease. The study findings could be useful guidelines for enhancing the cognitive function of elderly patients.
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It is unclear what non-pharmacological interventions to prevent cognitive decline should comprise. We systematically reviewed lifestyle and psychosocial interventions that aimed to reduce cognitive decline in healthy people aged 50+, and people of any age with Subjective Cognitive Decline or Mild Cognitive Impairment. We narratively synthesised evidence, prioritising results from studies rated as at lower Risk of Bias (ROB) and assigning Centre for Evidence Based Medicine grades. We included 64 papers, describing: psychosocial (n = 12), multi-domain (n = 10), exercise (n = 36), and dietary (n = 6) interventions. We found Grade A evidence that over 4+ months: aerobic exercise twice weekly had a moderate effect on global cognition in people with/ without MCI; and interventions that integrate cognitive and motor challenges (e.g. dance, dumb bell training) had small to moderate effects on memory or global cognition in people with MCI. We found Grade B evidence that 4+ months of creative art or story-telling groups in people with MCI; 6 months of resistance training in people with MCI and a two-year, dietary, exercise, cognitive training and social intervention in people with or without MCI had small, positive effects on global cognition. Effects for some intervention remained up to a year beyond facilitated sessions.
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This article examines the new demographic and epidemiological reality in Brazil, based on data collected and organized in the Health Supplement of the National Household Sam- ple Survey (PNAD-Health). It highlights the urgency of changes and innovations in health care paradigms for the elderly population with a preventive approach based on comprehensive education and care. As key concepts, the article emphasizes the need to preserve autonomy, par- ticipation, care, self-satisfaction, and the pos- sibility of elder citizens being active in various social contexts. It also discusses the contribu- tion by various authors to the discussion forum on Human Aging and the National Household Sample Surveys, coordinated by Cadernos de Saúde Pública/Reports in Public Health, featur- ing studies on access to and utilization of health services by the elderly, the epidemiological pat- tern of breast cancer in elderly women, and the validity of using proxy respondents in research on self-perceived health status, concluding that the PNAD data are consistent and can be used by the scientific community.
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Contrary to common sense, the population aging process is due to the decline in fertil- ity rather than mortality. The aging process began around the end of the 19th century in a num- ber of Western European countries, expanded to the rest of the so-called First World over the past century, and reached several Third World countries afterwards, including Brazil over the last decades. In the Brazilian case, a sharp and widespread fertility decline began by the end of the 1960s, and an accelerated population aging process can thus be expected. This process will nec- essarily be faster and with deeper structural changes, demographically speaking, than in First World countries, for two reasons: the fertility decline in Brazil was faster, and it took place in a population with a younger age structure.
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Objective: To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention. Participants: A planning committee of five scientists was established by the Centers for Disease Control and Prevention and the American College of Sports Medicine to organize a workshop. This committee selected 15 other workshop discussants on the basis of their research expertise in issues related to the health implications of physical activity. Several relevant professional or scientific organizations and federal agencies also were represented. Evidence: The panel of experts reviewed the pertinent physiological, epidemiologic, and clinical evidence, including primary research articles and recent review articles. Consensus process: Major issues related to physical activity and health were outlined, and selected members of the expert panel drafted sections of the paper from this outline. A draft manuscript was prepared by the planning committee and circulated to the full panel in advance of the 2-day workshop. During the workshop, each section of the manuscript was reviewed by the expert panel. Primary attention was given to achieving group consensus concerning the recommended types and amounts of physical activity. A concise "public health message" was developed to express the recommendations of the panel. During the ensuing months, the consensus statement was further reviewed and revised and was formally endorsed by both the Centers for Disease Control and Prevention and the American College of Sports Medicine. Conclusion: Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week.
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The revision of the Wechsler-Bellevue Adult Intelligence Scale retains the type of item categories but has numerous changes in the items. Standardization is based on a stratified sample of 1700 adults ages 16 to 64. Additional norms are given for ages above 64 based on a different group of subjects. Reliabilities for verbal, performance and full scale IQ's are .96, .93, and .97, and for the subtests range from .65 to .96. Manual includes directions for administering, IQ tables, and scaled score tables. Officially the title is to be abbreviated WAIS. (PsycINFO Database Record (c) 2012 APA, all rights reserved)