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Cognitive plasticity in older adults: Effects of cognitive training and physical exercise
Abstract
Cognitive training, physical activity, and exercise have often been reported to improve cognitive performance in older adults. This paper reviews some seminal and recent studies using these approaches to improve cognition and physical functioning in healthy older adults and in patients suffering from non-neurological chronic medical conditions. Results from cognitive training studies suggest that despite performance improvement in trained tasks, transfer effects appeared very limited. Surprisingly though, computerized dual-task training has been shown to improve balance and postural control in tests of physical functioning, suggesting that broad transfer can sometimes be observed. Physical exercise intervention studies generally found significant and large improvements in physical capacity, in some cognitive domains, and in quality of life. The benefits seem to be equivalent between frail and nonfrail participants. Overall, results reviewed here support the notion that cognitive plasticity for attentional control, as induced by cognitive training or physical activity and exercise, is preserved in late adulthood. Moreover, results of studies with patients at risk of cognitive decline also suggest that cognitive training and exercise interventions are promising nonpharmaceutical tools to help improve cognition in older at-risk individuals.
© 2015 New York Academy of Sciences.
... Ever since, hippocampal neurogenesis in response to aerobic exercise has been extensively demonstrated and replicated in rodent studies (Liu & Nusslock, 2018). In parallel, the field of cognitive neuroscience itself accumulated strong evidence that the human brain equally retains the structural malleability for plasticity well beyond childhood and into old age (Boyke et al., 2008;Eriksson et al., 1998;Kühn et al., 2016;Levine et al., 2002;Lövdén et al., 2010;Noack et al., 2009;Wenger & Kühn, 2021) and that such neuroplastic changes could be induced through physical exercise (Bherer, 2015;Colcombe et al., 2006;Cotman & Berchtold, 2002;Knaepen et al., 2010;Maass, 2015;Müller et al., 2020). ...
... After the publication of the first larger meta-analysis on AE intervention studies proved AE´s potential to significantly improve cognition and executive control functions roughly twenty years ago, numerous studies Bherer 2014Bherer , 2015Langlois et al., 2013;Predovan et al., 2012;Tolppanen et al., 2015) have repeatedly supported and manifested benefitting effects of AE on attention, processing speed, EF, memory and mood (both in acute bouts and over certain periods of time) for older individuals (for systematic reviews, see Barha et al., 2017a;Castells-Sánchez et al., 2019;Fissler et al., 2013;Gheysen et al., 2018;Guiney & Machado, 2012;Hindin & Zelinski, 2012;Kelly et al., 2014;Lü et al., 2016;Lustig et al., 2009;Northey et al., 2018;Smith et al., 2010;Voss et al., 2011). Merging the data of more than 30,000 participants worldwide, Sofi and colleagues (2011) corroborated a significant and consistent protection for all levels of AE against the occurrence of cognitive declin in their large meta-analysis on the impact of AE on cognition amongst healthy older nondemented subjects. ...
... The currently prevailing main hypothesis explaining PE's potential of inducing (positive) plastic changes is thus based on the assumption that PE may positively affect brain physiology by a) upscaling neurotrophin production, b) enhancing de novo generation of neurons, synapses (neuro-, and synaptogenesis) and glial cells, and c) benefitting blood flow vascularization, thereby enhancing the establishing of cognitive alterations with eventually lasting character (Chang et al., 2012;Erickson et al., 2011Erickson et al., , 2019Fissler et al., 2013;Hötting et al., 2016, Lauenroth, et al., 2016Maass et al., 2015;Voss et al., 2011). These direct structural and physiological effects of AE on the brain (considering hippocampal neurogenesis; angio-, and synaptogenesis) are believed to be based on changes in the expression of molecular growth factor cascades, namely BDNF for neuroplasticity and protection; and IGF-1 for neuro-and angiogenesis (Bherer, 2015). In the following, I will delve deeper into the nature of BDNF, IGF-1 and IGFBP-3, and what research has shed light on considering both factor systems, with special regards to why these may be interesting in understanding exercise-induced neuroplasticity in older adults. ...
Despite healthy aging being associated with brain atrophy and declines in overall cognitive
function, past research has highlighted the beneficial effect of greater physical fitness on brain
morphology and cognition, especially in older age. On the other hand, markers for neuronal
plasticity, as IGF-1, IGFBP-3, and BDNF namely, have experienced a rise in attention when
investigating the brain’s ability to induce structural and behavioural changes over the
lifespan. In this thesis, dynamics of serum-derived markers for neuronal plasticity (IGF-
1,IGFBP-3, BDNF) and general fitness (VO₂ and power at peak, BMI and body fat percentage)
were investigated in a sample of healthy older adults (N = 141; 63-78 years) at pre-intervention
and after six months of aerobic exercise (AE) (SP group, N = 71; 52.1% women) versus no AE
intervention (AC group, N = 70; 50.0% women), with special regards to differences between
male and female participants.
In sum, this work shows significant sex differences in dynamics of IGF-system markers (both
at baseline and after exhaustive AE) and fitness in healthy older adults. Overall,
dynamics between IGF-system markers and fitness measures showed sex differences and
were altered after a six-month AE intervention, challenging the dogma of little physiological
plasticity in aged bodies and indicating the pressing need to further investigate the effect of
biological sex on markers for neuronal plasticity throughout the lifespan.
Keywords: aerobic exercise, healthy aging, sBDNF, sIGF-1, sIGFBP-3, plasticity
... Neuroplasticity is the brain's ability to change and grow. It is used in three broad processes: normal development, learning, and recovery from injury (Bherer, 2015;Goghari & Lawlor-Savage, 2017;Goh & Park, 2009;Hill, Zewelanji, & Faison, 2015;Lenn, 1992;Park & Bischof, 2013;Sherman, Mauser, Nuno, & Sherzai, 2017). The brain's normal development is completed during early adulthood. ...
... As people age, they tend to lose some cognitive abilities (Barban et al., 2017;Bherer, 2015;Nordvik et al., 2014;Park & Bischof, 2013;Shah, Weinborn, Verdile, Sohrabi, & Martins, 2017). Children and younger adults naturally have more plasticity; ...
... To maintain good brain health, adults need social engagement, mental stimulation, good nutrition, exercise, sleep, and stress management (Barban et al., 2017;Bherer, 2015;Celidoni, Dal Bianco, & Weber, 2017;Muller & Shaikh, 2018;Ngandu, Lehtisalo, Solomon, Kivipelto, & T, 2015;Shakersain, Santoni, Larsson, & Xu, 2015). These factors are interconnected. ...
The purpose of this study was to examine the perceptions of adults who completed a LearningRx ThinkRx program. Organizations and employees often deal with low levels of self-efficacy, which can lead to lower levels of performance. Specifically, this study question was an examination of perceptions related to workplace self-efficacy. Brain training research has been shown to help increase academic skills, but little research has been conducted with self-efficacy and adults. The sample in this study were adults who completed their program between the years 2015 and 2018. The sample was chosen using purposeful sampling procedures among all participants who are now adults and completed their program between 2015 and 2018 at the Northern Colorado LearningRx center. Three forms of data were collected: artifact data, participant interviews, and member checking interviews. This qualitative case study examined the data using a thematic data analysis. The five themes found in this study were self-awareness, problem solving, emotional control, achievement, and leadership. There was direct support for the research question from the themes of self-awareness, problem solving, and emotional control. Though achievement and leadership did not directly support this research, futures researchers could explore if there is a connection between workplace self-efficacy and the these final two themes.
Keywords: brain training, cognitive training, LearningRx, adult self-efficacy, self- efficacy
... Following the approaches of these studies, we collected data on five cognitive tasks at five timepoints (Iowa Gambling Task, Flanker Task, Symbol Learning Task, Digit-Symbol Substitution Task, Time Production Task). We were able to track potential improvements in cognitive function as opportunities for socialisation became available, demonstrating plasticity of function as previously seen in older adults (e.g., Bherer, 2015;Karbach & Verhaeghen, 2014). Negative mood was also tracked across 12 weeks to consider the sensitivity of mental wellbeing to the gradual easing of restrictions. ...
... Changes in cognitive function are mapped across timepoints within Study 1 as COVID-19 restrictions eased. These data, and consideration of the many socio-demographic variables measured, may give further insight into cognitive reserve (e.g., Bherer, 2015;Karbach & Verhaeghen, 2014), if considered in line with data from an ageing population. ...
We present data from two studies examining how COVID-19 restrictions affected health behaviours (alcohol consumption, diet, sleep quality, and physical activity levels), mental wellbeing (negative mood) and cognitive function (decision making, attention, learning, working memory, and time perception) in association with socio-demographic factors. Study 1 assessed participants in Scotland and presents cognitive function data for five timepoints. Study 2 is transnational, assessing participants in Scotland and Japan. Data are stored as CSV files. Reuse may involve examining further effects of pandemic enforced social isolation or serve as baseline data when assessing social isolation in expeditions or ageing.
... La AF se define como todos los movimientos del cuerpo que implican un gasto energético, incluso las actividades de la vida diaria (Merino-Marban et al., 2015). Se ha demostrado que la práctica de la AF acarrea varios beneficios para la salud en la mejora de la composición corporal, reducción de riesgo de enfermedades cardiovasculares, mejora de la autoestima, disminución del estrés, aumento de la capacidad de atención, construcción de relaciones sociales y desarrollo de valores (Bherer, 2015;Chaput et al., 2016). Es por eso, que las instituciones de educación superior se preocupan por implementar asignaturas orientadas a la formación integral de los alumnos, incluyendo la promoción de la AF, con intención de mejorar la salud de los estudiantes (Galmés-Panadés & Vidal Conti, 2019). ...
Objetivo. Determinar el efecto de una intervención de promoción de actividad física (AF) basada en aplicaciones móviles sobre la composición corporal de estudiantes universitarios durante el confinamiento por pandemia de COVID 19. Métodos. Participaron 21 estudiantes universitarios (10 hombres, 11 mujeres, edad 22.81 ± 4.88 años), se evaluó composición corporal, frecuencia de alimentos y niveles de AF antes (Pre) y después (Post) de la implementación de un programa de ocho semanas de AF utilizando aplicaciones móviles. Resultados. Los cambios observados en composición corporal fueron en índice de masa grasa (IMG) y masa grasa (p < .05); sin embargo, los tamaños de efecto fueron triviales. El gasto energético fue mayor a la ingesta energética en Pre (p < .05) y Post (p < .01); también, el gasto energético fue mayor en Post comparado con Pre (p < .01). En Post se observó relación entre AF total y reducciones de masa grasa, porcentaje de masa grasa e IMG (p < .05). Conclusiones. Las intervenciones de AF utilizando aplicaciones móviles provocan un aumento en el gasto energético; sin embargo, los cambios en composición corporal fueron triviales. Por lo tanto, se sugiere que las intervenciones de AF usando aplicaciones móviles sean de mayor duración, además de que se complementen con control dietario. Palabras clave: Teléfono inteligente, salud, ejercicio, masa grasa, pandemia. Abstract. Objective: To determine the effect of a mobile application-based physical activity (PA) promotion intervention on the body composition of university students during the COVID-19 pandemic lockdown. Methods: 21 university students participated (10 men, 11 women, aged 22.81 ± 4.88 years), their body composition, food frequency, and PA levels were evaluated before (Pre) and after (Post) the implementation of an eight-week PA program using mobile applications. Results: The observed changes in body composition were in fat mass index (FMI) and fat mass (p < .05); however, the effect sizes were trivial. Energy expenditure was greater than energy intake in Pre (p < .05) and Post (p < .01); also, energy expenditure was higher in Post compared with Pre (p < .01). In Post, a relationship between total PA and reductions in fat mass, percentage of fat mass, and FMI was observed (p < .05). Conclusions: PA interventions using mobile applications result in increased energy expenditure; however, changes in body composition were trivial. Therefore, it is suggested that PA interventions using mobile applications should be of longer duration and be complemented with dietary control. Keywords: smartphone, health, exercise, pandemic.
... The prefrontal cortex (PFC) and hippocampus volume decrease by 1-2% annually in individuals over 55 years of age [6]. Changes in brain volume, especially in prefrontal regions and the hippocampus, have been suggested to account for the age-related cognitive decline often occurring in memory and executive functions tasks [7,8]. Additionally, separate brain regions that interact to subserve higherorder cognitive functions show less-coordinated brain activation with aging; this reduced coordination between the anterior medial PFC with posterior cingulate/retrosplenial is associated with poorer cognitive functioning, including executive functioning [9]. ...
Background and Objectives: To date, understanding age-related changes in cognitive processes during heat exposure still needs to be better-understood. Thus, the main aim of the current study was to evaluate the effects of whole-body hyperthermia (WBH), i.e., a ≈2.5 °C increase in rectal temperature (Tre) from overnight-fast baseline value, on cognitive functioning in old and young men and to explore factors, such as stress and thermophysiological strain, that could influence such changes. Materials and Methods: Ten young (19-21 years of age) and nine old (61-80 years of age) healthy men underwent an experimental trial with passive lower-body heating in hot water immersion (HWI) at 43 °C (HWI-43 °C) until Tre reached 39 °C in old adults and 39.5 °C in young adults. Cognitive performance and cortisol concentration were assessed before and after HWI, and the physiological strain index (PSI) was assessed during HWI-43 °C. Results: PSI was lower and cortisol concentration was greater after HWI-43 °C in the old group compared with the young group (p < 0.05). Surprisingly, hyperthermia improved cognitive flexibility only in old adults, whereas short-term and visual recognition memories were maintained in both age groups. Conclusions: A ≈2.5 °C increase in rectal temperature can improve executive function in old adults, and this increase parallels the increased cortisol concentration and the lower thermophysiological strain under severe WBH conditions.
... Cognitive training studies provide insights into how cognition would change after engaging in intellectually stimulating activities. Previous studies have investigated the effectiveness of non-pharmacological intervention for healthy older adults (Bherer 2015;Kivipelto, Mangialasche, and Ngandu 2018;Kwok et al. 2013). The training programs ranged from physical exercises and puzzle games, to a combination of both. ...
Bilingualism is reported to be beneficial to cognition, especially in tasks related to inhibitory control. However, previous studies on bilingualism and cognition often recruited lifelong bilinguals who had decades to practice the use of two languages. In line with cognitive training studies which found intellectually stimulating activities could improve older adults’ cognition, it is possible that older adults might also enjoy the cognitive benefits of learning a new language. However, previous studies on using language learning as cognitive training yielded inconsistent results. It is postulated that the motivation of the students or the learning success might contribute to the amount of cognitive improvement. Fourteen Cantonese-speaking older adults were recruited to attend a six-week elementary English course. Their cognitive abilities were measured before and after the course by a comprehensive cognitive battery. Results suggested that those who were more successful in learning showed cognitive changes towards the pattern of a lifelong bilingual. The changes are believed to originate from the combination of the practice of inhibition in bilingualism and the learning process itself. It is plausible that older adults could enjoy the cognitive advantage brought by bilingualism even if they begin learning a foreign language at an older age.
... The majority of these programmes followed a similar approach, with reality orientation, discussion and reminiscence being core intervention components. While this traditional approach to CS has been extensively supported for benefiting cognition (Woods et al., 2012), these changes in cognition do not appear to transfer to ADL performance, a phenomenon previously noted by Bherer (2015). This overall lack of evidence supporting CS programmes for improving ADL outcomes has been reflected in previous systematic reviews ( Aguirre et al., 2013;Woods et al., 2012). ...
Introduction
Dementia is a progressive syndrome that interferes with the individual’s ability to perform activities of daily living (ADL). Cognitive stimulation (CS) is a non-pharmacological approach aimed to mitigate the impact of dementia symptoms. While CS has been shown to provide benefits for cognition and quality of life, the evidence supporting its use in improving ADL outcomes is reduced. The aim of this review was to chart what is known from the literature about the use of CS in improving ADL outcomes.
Method
A scoping review of the use of CS in improving ADL outcomes for individuals with mild-to-moderate dementia was conducted, following a scoping review methodological framework. Eight databases were searched, including all articles published up until June 2022.
Findings
A three-step search strategy yielded 788 results. Following screening and review, 36 papers met the inclusion criteria for this review. Studies were charted and discussed in the areas of (1) cognitive stimulation therapy; (2) group CS programmes; (3) multi-component CS interventions; (4) individual CS programmes and (5) other types of CS.
Conclusion
The review identified a range of CS programmes from across 13 countries worldwide. Multi-component CS interventions involving ADL-focused activities reported the most benefits for ADL outcomes.
... The cognitive performance that older adults achieve and retain after undergoing process-based cognitive training might be attributed to their cognitive plasticity. Cognitive plasticity in older adults is preserved to a large extent, and even fairly short cognitive training programs can produce (partially specific) training and transfer effects [38]. Distinct design characteristics of cognitive training program may explain those improvements. ...
Abstract Background Cognitive training shows promising effects for improving cognitive domains in individuals with mild cognitive impairment (MCI), including the crucial predictive factor of executive function (EF) for dementia prognosis. Few studies have paid sufficient emphasis on the training-induced effects of cognitive training programs, particularly with regards to targeting EF. A process-based multi-task adaptive cognitive training (P-bM-tACT) program targeting EF is required to examine direct, transfer, and sustainability effects in older adults with MCI. Objective This study aimed to evaluate the direct effects of a P-bM-tACT program on EF, the transfer effects on untrained cognitive domains, and further explore the sustainability of training gains for older adults with MCI in the community. Methods In a single-blind, randomized controlled trial, 92 participants with MCI were randomly assigned to either the intervention group, participating in a P-bM-tACT program (3 training sessions/week, 60 min/session for 10 weeks) or the wait-list control group, accepting a health education program on MCI (1 education session/ twice a week, 40–60 min/session for 10 weeks). The direct and transfer effects of the P-bM-tACT program were assessed at baseline, immediately after 10 weeks of training, and the 3-month follow-up. Repeated measures analysis of variance and a simple effect test were used to compare the direct and transfer effects over the 3-time points between the two groups. Results The P-bM-tACT program yielded a greater benefit of direct and transfer effects in the intervention group participants than in the wait-list control group. Combined with the results of simple effect tests, the direct and transfer effects of participants in the intervention group significantly increased immediately after 10 weeks of training compared to the baseline (F = 14.702 ~ 62.905, p
... Previous studies have investigated the effectiveness of the non-pharmacological intervention on both healthy older adults (Jackson et al., 2012;Kwok et al., 2013) and pathological populations, including schizophrenia (Genevsky et al., 2010), MCI (Belleville, 2008;Hyer et al., 2016;Maffei et al., 2017) and mild to moderate dementia patients (Bahar-Fuchs et al., 2019). The intervention methods varied from physical exercises to cognitive tasks, or a combination of both (Bherer, 2015). One of the most well-known training programmes is The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER study) (Kivipelto et al., 2013), which involved over 1200 individuals with cognitive decline risk undergoing a two-year multidimensional programme. ...
Full text available here: https://theses.lib.polyu.edu.hk/handle/200/12383
Bilingualism has been attracting interest from the cognitive science field for years as it is suggested to be a protective factor against cognitive decline in ageing. It is often reported that bilinguals performed better than monolinguals in inhibitory control tasks. The mechanism behind the better inhibitory control was that bilinguals would have to suppress the interference from the unwanted language all the time, and such linguistic control is thought to be, at least partially, overlapped with the general inhibitory control network. However, inconsistent results have been reported. It is common for the literature to compare monolinguals with bilinguals as two homogenous groups without considering the individual variations between and among them. Moreover, as the Adaptive Control Hypothesis (Green & Abutalebi, 2013) suggested, the interaction context affects the cognitive demand in controlling the languages. Three experiments were designed to explore how different aspects of bilingualism contribute to cognition and the bilingual advantage effect.
The first experiment recruited older adults to complete a comprehensive set of cognitive tests together with questionnaires on their language and demographic profiles. Comparing the monolinguals and bilinguals, we found the classic bilingual advantage effect: bilinguals scored higher in the Montreal Cognitive Assessment (MoCA), indicating better cognitive status. Moreover, within the bilinguals, the scores in the cognitive battery were predicted with demographic and linguistic variables using linear regression analysis. We found that L2 proficiency predicts better inhibitory control and verbal ability performance in lifelong bilinguals. We propose that, because our participants are L1-dominant speakers, only the sufficiently proficient L2 would provide enough interference in the practice of linguistic inhibition control.
The second experiment investigated the cognitive changes in older foreign language learners. Older adults were recruited to study in an elementary English course for six weeks, with cognitive tests taken before and after the course. Although the statistical results between the intervention group and the active and passive control groups were not significant, the language learning-induced differences were observed in some tasks, including the accuracy of Picture Naming and the Conflicting Effect in the Attention Network Task. Correlation analysis suggested that successful language learners showed an improvement in inhibitory control and a decline in verbal fluency.
The third experiment investigated the organisation of the mental lexicon through an interesting language phenomenon in Hong Kong: dense code-switching. Whereas the literature often suggested that the comprehension of code-switching requires a switch in lexicon and is therefore challenging, we found that switching lexicon was needed only in the case of non-habitual word usage, regardless of whether it was unilingual and code-switching. From the result of this experiment, we proposed that the language input from the community had formed the bilingual prefabs, which integrated into the dominantly Cantonese lexicon.
Collectively, we suggest that the environment, language and cognition form a looping circle in that each component is interrelated. Moreover, they each affect the organisation of the bilingual mental lexicon and the retrieval of concepts from the lexicon. In view of that, we propose the Experience-based Bilingual Mental Lexicon Model, which is modified based on the Revised Hierarchical Model (Kroll & Stewart, 1994). Two critical assumptions are incorporated into the existing model: (1) the language lexicon is organised by experience but not by language origin, and (2) language dominance is dynamic. We believe the proposed model could better capture the dynamic change of language by experience. It could explain how individual differences contribute to the bilingual advantage effect.
References:
Green, D. W., & Abutalebi, J. (2013). Language control in bilinguals: The adaptive control hypothesis. Journal of Cognitive Psychology, 25(5), 515-530. https://doi.org/10.1080/20445911.2013.796377
Kroll, J. F., & Stewart, E. (1994). Category interference in translation and picture naming: Evidence for asymmetric connections between bilingual memory representations. Journal of Memory and Language, 33(2), 149-174. https://doi.org/10.1006/jmla.1994.1008
... On the other hand, Peng et al. [17] added a new perspective by introducing virtual reality fitness, which they found to have a positive effect on exercise, general well-being, and physical-psychological health, providing a promising solution to promote exercise and general well-being during periods of exercise restrictions. Although the effects of physical exercise are generally studied among elder subjects affected by neurodegenerative diseases, studies have shown that these benefits are much the same between frail and non-frail people [18]. The purpose of this study is to explore the role of physical exercise during the pandemic through the investigation of different issues: firstly, the existence of a link between the time spent in physical activity during the lockdown and the perceived health condition, depressive and somatic symptomatology, and life satisfaction; secondly, we expect to find associations among the SF-12 component summaries and the other psychological outcomes; finally, the last purpose is to explore how both physical and psychological variables are predictive of PCS-12 and MCS-12. ...
The COVID-19 pandemic has exerted an effect on the general population that went over every expectation. To explore the effect of physical exercise (PE) during the national lockdown in Italy, a survey was drawn up and administered to a sample composed of 208 subjects. The questionnaire comprised 81 multiple-choice items, including sociodemographic data, health-related questions, and assessment of physical exercise, satisfaction with life, depression, and personality. The purpose of this study is to explore the role of physical exercise during the outbreak following the present hypothesis: first, if a link exists between the time spent on physical exercise during the lockdown and the perceived health condition, depressive and somatic symptomatology, and life satisfaction; second, to find associations among the SF-12 component summaries and the other psychological outcomes; and finally, to explore how physical and psychological variables are predictive of PCS-12 and MCS-12. The results showed that both vigorous and moderate physical exercise was strongly correlated with psychological variables, with statistically significant negative correlations found between age and physical exercise. Additionally, significant positive correlations were observed between physical exercise and mental health indices, such as MCS-12 and SWLS, whereas negative correlations were found with BDI, PCS-12, and SOM-H. The correlation analysis also revealed that physical and individual mental health summaries were associated with psychological outcomes, with statistically significant negative correlations found between PCS-12 and MCS, PCS-12 and SOM-H, and MCS-12 and BDI scores. Regression analysis showed that physical activities and psychological status both had a direct influence on perceived mental and physical well-being during the lockdown, accounting for 56.7% and 35.5% of the variance, respectively. The p-values for the significant correlations ranged from
... Performing demanding cognitive activities that target specific skills has been associated with improved neuroplasticity and Cognitive Reserve (CR) in older adults (Stern 2009). Thus, CR has been associated with a delay in the onset and progression of cognitive impairment (Anthony and Lin 2018;Bherer 2015;Nelson et al. 2021). Likewise, meta-analysis of data has shown that cognitive training produces an increase in volumetric tissue in cortical and subcortical regions, thus improving the biological correlates of CR (Duda and Sweet 2020;Nguyen, Murphy, and Andrews 2019a). ...
... There is a vast amount of literature that covers the cognitive effects of different types of multimodal interventions: (1) combined interventions, where physical and cognitive exercise components are administered sequentially [57,79,[83][84][85][86][87]; (2) dual-task interventions, where the components are administered as separate types of tasks at the same time [88][89][90][91][92][93][94][95]; and (3) interactive interventions, a specialized form of exergaming, in which the actions in one component directly affect the other synergistically [15,17,44,[96][97][98][99][100][101][102][103]. The theory that integrated (mental + physical exercise) cognitive interventions slow the decline in cognition in older adults with MCI has led to an increase in RCTs. ...
Facing an unrelenting rise in dementia cases worldwide, researchers are exploring non-pharmacological ways to ameliorate cognitive decline in later life. Twenty older adults completed assessments before and after a single bout of interactive physical and cognitive exercise, by playing a neuro-exergame that required pedaling and steering to control progress in a tablet-based video game tailored to impact executive function (the interactive Physical and Cognitive Exercise System; iPACES v2). This study explored the cognitive and biomarker outcomes for participants with mild cognitive impairment (MCI) and normative older adults after 20 min of pedal-to-play exercise. Neuropsychological and salivary assessments were performed pre- and post-exercise to assess the impact. Repeated-measures ANOVAs revealed significant interaction effects, with MCI participants experiencing greater changes in executive function and alpha-amylase levels than normative older adults; within-group changes were also significant. This study provides further data regarding cognitive effects and potential mechanisms of action for exercise as an intervention for MCI.
... Thus, non-pharmacological interventions, namely cognitive interventions (CIs), have gained particular relevance given the increased number of people living with dementia [10][11][12][13]. The benefits of CIs may include neuroplastic changes [14][15][16][17] and an increase in cognitive reserve [18,19], which facilitate coping with brain diseases. ...
Background:
In a society increasingly committed to promoting an active life in the community, new resources are needed to respond to the needs of citizens with Alzheimer's disease and other forms of dementia. The potential of several individual cognitive interventions to be provided by caregivers has been explored in the literature.
Objective:
To synthesize the best available evidence on the effectiveness of caregiver-provided individual cognitive interventions in older adults with dementia.
Methods:
Systematic review of experimental studies on individual cognitive interventions for older adults with dementia. An initial search of MEDLINE and CINAHL was undertaken. Another search for published and unpublished studies was performed on major healthcare-related online databases in March 2018 and updated in August 2022. This review considered studies that included older adults with dementia, aged 60 years and over. All studies that met the inclusion criteria were assessed for methodological quality using a JBI standardized critical appraisal checklist. Data were extracted using a JBI data extraction form for experimental studies.
Results:
Eleven studies were included: eight randomized controlled trials and three quasi-experimental studies. Caregiver-provided individual cognitive interventions had several beneficial effects in cognitive domains, including memory, verbal fluency, attention, problem-solving, and autonomy in activities of daily living.
Conclusion:
These interventions were associated with moderate improvements in cognitive performance and benefits in activities of daily living. The findings highlight the potential of caregiver-provided individual cognitive interventions for older adults with dementia.
... Nevertheless, the manifestation or not of symptoms in neurological and neuropsychiatric diseases is the result of the balance between the processes of neurodegeneration and neuroprotection [8]. Therefore, despite facing a decline in cognitive abilities, the human brain maintains the ability to adapt to environmental changes even at advanced ages [9]. Thus, recent studies have found that there are preventive interventions that can help maintain and improve cognitive function [10] and even reverse the cognitive deterioration in people with MCI to the extent of returning to a normal functioning [11][12][13][14]. ...
The prevalence of people over 60 years of age with cognitive impairment has increased in recent decades. As a consequence, numerous computerized cognitive trainings (CCT) have been developed. This pilot study aimed to determine the effectiveness of the CCT with VIRTRAEL in improving older adults’ cognition. Fifty-five participants (x¯ = 72.7 years; SD = 6.5) underwent CCT, and twenty participants (x¯ = 76.1 years; SD = 7.6) received face-to-face cognitive stimulation with a paper-and-pencil methodology. Both trainings were conducted in nine sessions (45–60 min each). Participants completed a pre-post training neuropsychological assessment. ANCOVAs and the standardized clinical change were performed. VIRTRAEL’s group showed a significant and greater improvement in verbal learning (p < 0.006) and delayed recall (p ≤ 0.001), working memory (p < 0.005), abstract (p < 0.002) and semantic reasoning (p < 0.015), and planning (p < 0.021). Additionally, more large clinical changes (d > 0.8) were found in the VIRTRAEL condition (in verbal learning and delayed free and cued recall) than in the standard group. Here we show that the CCT with VIRTRAEL is effective in improving cognitive function in older adults and is superior to the standard format. These preliminary findings indicate that CCT is a useful tool potentially applicable in the fight against cognitive symptomatology associated with aging and neurodegenerative diseases. VIRTRAEL represents a breakthrough in this field as it is inexpensive and easily accessible to any older person, regardless of whether they live far from health care resources.
... For the analysis, this confounding factor was inserted as a continuous variable. Other covariates were the number of falls in the last 12 months [81], the number of different types of medications consumed daily [82,83], and comorbidities [84,85]. All this information was obtained through face-to-face interviews. ...
This study aims to investigate the effects of dual-task physical–cognitive the training on body balance (BB), gait performance (GP), lower limb muscle strength (LEMS), and cognitive performance (CP) in a group of cognitively normal older adult women (n = 44; 66.20 ± 4.05 years). Of these, 22 were randomly allocated to the dual-task training (DT) group, and 22 participated in the control group (CG). Assessments were performed at baseline, after 12 weeks of intervention, and at the end of 12 weeks of follow-up, using the following instruments: Timed Up & Go (TUG), Timed Up & Go manual (TUGm), Timed Up & Go cognitive (TUGc), Balance Test (TEC), sit-to-stand test (STS), and verbal fluency test (VF). After 12 weeks of DT training, participants showed a significant time × group interaction in all motor assessments (BB, GP, LEMS), as well as in three cognitive tests (VF-grouping, VF-exchange, VF-total). No time–group interaction effect was indicated for the VF-category test. At all evaluation times, CG members maintained constant physical and cognitive performance. We conclude that 12 weeks of physical–cognitive DT training was effective in promoting BB, GP, and LEMS, as well as CP in cognitively normal older adult women, with lasting effects up to 12 weeks after the intervention.
... Based on this review, the applicability of CT, characterized by standard tasks for improving specific cognitive functions, is much broader than that of CS and CR, potentially because CT may increase functional connectivity in the medial temporal lobe and cause topological changes in the anterior cingulum in individuals with AD (Barban et al., 2017). Importantly, CT combined with other nonpharmacological interventions, including physical exercise, can influence brain plasticity through distinct and complementary paths (Bherer, 2015). A recent study found that simultaneous rather than sequential training might be better to achieve maximal benefit (Gavelin et al., 2021). ...
Accumulating evidence has shown the effectiveness of cognitive interventions, which can be divided into cognitive training (CT), cognitive stimulation (CS), cognitive rehabilitation (CR), and combined interventions (i.e., cognitive interventions combined with other non-pharmacological interventions such as physical exercise), in individuals with Alzheimer’s disease (AD). However, the effectiveness of cognitive interventions varies greatly among studies and more comprehensive studies are required. We aimed to evaluate whether the current evidence shows that cognitive interventions are effective at improving cognition, neuropsychiatric symptoms, depression, quality of life, and basic activities of daily living among individuals with possible or probable AD. Randomized controlled trials of all types of cognitive intervention were identified for inclusion in pairwise and network meta-analyses. There was a moderate and statistically significant post-intervention improvement in global cognition among individuals with AD for all types of cognitive intervention compared to control interventions (39 studies, g = 0.43, 95% CI: 0.28 to 0.58, p < 0.01; Q = 102.27, df = 38, p < 0.01; I² = 61.97%, τ² = 0.13). Regarding the specific types of cognitive intervention, combined interventions had the highest surface under the cumulative ranking curve (SUCRA) value (90.7%), followed by CT (67.8%), CS (53.4%), and lastly CR (28.9%). Significant effects of cognitive interventions were also found for working memory, verbal memory, verbal fluency, confrontation naming, attention, neuropsychiatric symptoms, basic activities of daily living, and quality of life.
... Regular physical exercise was reported to contribute to neuroplasticity, neurogenesis, and learning skills (Maharjan et al., 2020). The other way around, when cognitive functions are preserved, people are more likely to engage in health behaviour such as regular exercise (Bherer, 2015). All in all, in order to have a healthy brain into old age, one needs to combine physical factors (e.g. ...
Similar to physical ageing, cognitive ageing is mostly associated with decline and loss (e.g. in terms of memory, executive functions, visual and linguistic abilities) making it hard to envision positive changes. Both negative stereotypes (e.g. older people suffering from dementia) and positive stereotypes of ageing (e.g. wise older individuals) influence cognitive evolution across the later stages of life. Understanding both gains and losses associated with cognitive ageing and proposing interventions that foster strengths rather than prevent deficits represents an interesting challenge. This chapter explores cognitive ageing and development from a positive psychology perspective. First, it examines the potential meanings of cognitive development in midlife and older age, as proposed by theoretical models and the perspectives of ageing individuals. Then, it goes on to summarize a few instruments that can help measure cognitive improvement in older age. Next, it explores the relevance of cognitive development and how it is linked to other forms of development in midlife and older age (i.e. emotional growth, social skills improvement, physical and personality change). Finally, the chapter provides information on how to foster cognitive development among older individuals and prevent dementia by using positive psychology principles and a developmental assets approach.
... Physical exercises with intensities between 40 and 75% of maximal capacity are thought to have beneficial effects on memory, cognitive function, and neuroprotection (Dishman et al., 2006;Cotman et al., 2007;Mueller, 2007;Draganski and May, 2008). An increasing body of evidence supports that PEs induce remarkable functional and neuroanatomical plasticity in the mature brain, such as neurogenesis, angiogenesis, synaptic plasticity, and dendritic morphological remodeling (Bherer, 2015;Cassilhas et al., 2016;Phillips, 2017;Suarez-Manzano et al., 2018;Rassovsky and Alfassi, 2019). The hippocampus is one of the brain structures with the highest level of neuroplasticity (Bartsch and Wulff, 2015) and is also an area of neurogenesis in the sub-granular zone of the dentate gyrus. ...
Adaptive neuroplasticity is a pivotal mechanism for healthy brain development and maintenance, as well as its restoration in disease- and age-associated decline. Management of mental disorders such as attention deficit hyperactivity disorder (ADHD) needs interventions stimulating adaptive neuroplasticity, beyond conventional psychopharmacological treatments. Physical exercises are proposed for the management of ADHD, and also depression and aging because of evoked brain neuroplasticity. Recent progress in understanding the mechanisms of muscle-brain cross-talk pinpoints the role of the myokine irisin in the mediation of pro-cognitive and antidepressant activity of physical exercises. In this review, we discuss how irisin, which is released in the periphery as well as derived from brain cells, may interact with the mechanisms of cellular autophagy to provide protein recycling and regulation of brain-derived neurotrophic factor (BDNF) signaling via glia-mediated control of BDNF maturation, and, therefore, support neuroplasticity. We propose that the neuroplasticity associated with physical exercises is mediated in part by irisin-triggered autophagy. Since the recent findings give objectives to consider autophagy-stimulating intervention as a prerequisite for successful therapy of psychiatric disorders, irisin appears as a prototypic molecule that can activate autophagy with therapeutic goals.
... This is consistent with the literature, including several studies in similar populations (60)(61)(62). Indeed, physical activity has been positively associated with mood profile and inversely associated with a cognitive decline for multiple reasons, including not only direct physiological effects (63,64) but also the psychosocial effects of the entire group program that participants are engaged (65). Our data corroborate with previous evidence demonstrating that exercise training is an efficient strategy to improve not only physical performance but also overall mental health. ...
This is a longitudinal single-arm clinical trial aimed to investigate whether exercise training would modify the whole-blood methylation profile in healthy women. A total of 45 subjects were engaged in an exercise training protocol during a 14-week follow-up, consisting of aerobic cardiorespiratory and muscle strength exercises. Subjects were evaluated at baseline (PRE), after 7 weeks of exercise training (POST 7), and after 14 weeks of exercise training (POST 14). Functional primary outcomes included anthropometric, blood pressure, biochemical measurements, physical tests, and global health assessments. Blood samples were collected at each time point to determine the methylation profile using a DNA methylation array technique screening up to 850k different sites. Exercise training decreased blood pressure and triglyceride levels and enhanced physical performance, including upper and lower-body maximum strength. Moreover, exercise training improved markers of quality of life. In the array analysis, 14 weeks of exercise training changed the methylation of more than 800 sites. Across these differentially methylated sites, we found that differentially methylated sites in the promoter region were more hypermethylated after exercise training, suggesting that this hypermethylation process may affect the transcription process. When inputting the differentially methylated sites in pathway analysis, we found several metabolic pathways, including AMPK signaling, TGF-beta signaling, and insulin signaling. This study demonstrates that exercise training promotes a robust change in the whole-blood methylation profile and provides new insights into the key regulators of exercise-induced benefits.
... In addition to CBT, cognitive training also helps to improve the cognitive function of patients [155]. Cognitive training interventions, which often use in-house computerbased training software or recently commercialized packages, are a way to understand how the brain adapts to new and challenging situations [156]. ...
Heart failure (HF) is associated with multiple organ dysfunction and many comorbidities. Its incidence is high among the elderly and is a major health burden worldwide. Cognitive impairment (CI) is highly prevalent in older patients with HF, which is an abnormality in one or more of the items of cognition, attention, memory, language, psychomotor function, and visual spatial acuity. Studies have shown that the incidence of CI in HF patients is between 13 and 54%, and patients with both conditions have poor self-care ability and prognosis, as well as increased mortality rates. However, the mechanisms of CI development in HF patients are still unclear. In this review, we describe the epidemiology and risk factors as well as measures of improving CI in HF patients. We update the latest pathophysiological mechanisms related to the neurocognitive changes in HF patients, expounding on the mechanisms associated with the development of CI in HF patients.
... Literature is now abundant on the strong links between cognitive processes (mainly executive functions and attention) and gait [9,10]. Recent reviews and meta-analyses highlighted the benefits of computerized cognitive training on brain adaptations and mobility outcomes [11,12]. Encouraging results were observed, especially on balance [13] and on SWS, with a 0.13 m.s −1 improvement [14] among a sample of sedentary older adults after a three-month intervention focused on executive control. ...
The application of interventions to enhance mobility in ecological settings remain understudied. This study was developed to evaluate the feasibility of training methods in a community centre and to evaluate their impact on mobility outcomes. Fifty-four participants were randomized to one of three 12-week training programs (three times/week): aerobic (AE), gross motor abilities (GMA) or cognitive (COG). Feasibility was evaluated by calculating adherence, feedback from participants and long-term participation. The impact of these interventions on mobility was assessed by comparing pre- and post-program on Timed-up-and-go (TUG) and spontaneous walking speed (SWS) performances. Results showed relatively high rates of adherence (85.1%) and long-term participation (66.7%), along with favorable feedbacks. SWS significantly improved in COG (0.10 ± 0.11 m.s−1; p = 0.004) and AE (0.06 ± 0.11 m.s−1; p = 0.017) groups, and TUG performance was maintained in all groups. Results of this feasibility study demonstrated successful implementation of physical and cognitive training programs, encouraging the development of real-world applications.
... In a meta-analysis of modifiable factors related to cognitive function and dementia [2], physical activity was considered an important modifiable factor [3][4][5]. Therefore, many studies have evaluated the effects of physical activity on cognitive function in older adults [6][7][8][9][10]. ...
This cross-sectional, observational study aimed to integrate the analyses of relationships of physical activity, depression, and sleep with cognitive function in community-dwelling older adults using a single model. To this end, physical activity, sleep, depression, and cognitive function in 864 community-dwelling older adults from the Suwon Geriatric Mental Health Center were assessed using the International Physical Activity Questionnaire, Montgomery-Asberg Depression Rating Scale, Pittsburgh Sleep Quality Index, and Mini-Mental State Examination for Dementia Screening, respectively. Their sociodemographic characteristics were also recorded. After adjusting for confounders, multiple linear regression analysis was performed to investigate the effects of physical activity, sleep, and depression on cognitive function. Models 4, 5, 7, and 14 of PROCESS were applied to verify the mediating and moderating effects of all variables. Physical activity had a direct effect on cognitive function (effect = 0.97, p < 0.01) and indirect effect (effect = 0.36; confidence interval: 0.18, 0.57) through depression. Moreover, mediated moderation effects of sleep were confirmed in the pathways where physical activity affects cognitive function through depression (F-coeff = 13.37, p < 0.001). Furthermore, these relationships differed with age. Thus, the associations among physical activity, depression, and sleep are important in interventions for the cognitive function of community-dwelling older adults. Such interventions should focus on different factors depending on age.
... In Gavelin et al.'s study, burnout levels were positively correlated with neuronal activation in the rostral prefrontal cortex, posterior parietal cortex, and striatum, as observed by fMRI, and striatal activity decreased after therapy as a result of improved burnout levels [26]. The Shirom-Melamed Burnout Questionnaire (SMBQ) [31] containing 22 items in four subscales was used to evaluate burnout level.Cognitive training may bring improvements, but this requires further research on larger patient samples [32][33][34]. ...
Occupational burnout, manifested by emotional exhaustion, lack of a sense of personal achievement, and depersonalization, is not a new phenomenon, but thusfar, there is no clear definition or diagnostic guidelines. The aim of this article wasto summarize all empirical studies to date that have used medical neuroimaging techniques to provide evidence or links regarding changes in brain function in occupational burnout syndrome from a neuroscientific perspective, and then use these to propose a fuzzy-based computational model of burnout.A comprehensive literature search was conducted in two major databases (PubMed and Medline Complete). The search period was 2006–2021, and searches were limited to the English language. Each article was carefully reviewed and appropriately selected on the basis of raw data, validity of methods used, clarity of results, and scales for measuring burnout. The results showed that the brain structures of patients with job burnout that are associated with emotion, motivation, and empathy weresignificantly different from healthy controls. These altered brain regions included the thalamus, hippocampus, amygdala, caudate, striatum, dorso-lateral prefrontal cortex, anterior cingulate cortex, posterior cingulate cortex, anterior insula, inferior frontal cingulate cortex, middle frontal cingulate cortex, temporoparietal junction, and grey matter. Deepening our understanding of how these brain structures are related to burnout will pave the way for better approaches fordiagnosis and intervention. As an alternative to the neuroimaging approach, the paper presents a late proposal of the PLUS (personal living usual satisfaction) parameter. It is based on a fuzzy model, wherein the data source is psychological factors—the same or similar to the neuroimaging approach. As the novel approach to searching for neural burnout mechanisms, we have shown that computational models, including those based on fuzzy logic and artificial neural networks, can play an important role in inferring and predicting burnout. Effective computational models of burnout are possible but need further development to ensure accuracy across different populations. There is also a need to identify mechanisms and clinical indicators of chronic fatigue syndrome, stress, burnout, and natural cognitive changes associated with, for example, ageing, in order to introduce more effective differential diagnosis and screening.
... Additionally, exercise has long been known to have protective effects on cognitive decline (Ashworth et al., 2005;Bherer, 2015;Borde et al., 2015;Desjardins-Crépeau et al., 2016;Liu-Ambrose et al., 2012). Qi et al. (2021) sought to use this principle and determine whether Qigong, a type of Chinese physical exercise and breathing control, had protective effects against COVID-19 associated cognitive decline. ...
Objective:
The effects of COVID-19 infection were initially thought to be limited to the respiratory system; however, recent literature suggests that the virus has systemic effects, even leading to cognitive deficits. The objective of this study is to review COVID-19 related literature to determine whether there is an association between COVID-19 infection and the development of cognitive deficits.
Method:
A search for articles relevant to COVID-19, cognitive deficits, the Montreal Cognitive Assessment Tool (MoCA), and the geriatric population was performed on the MEDLINE, CINAHL, and APA PsychInfo databases.
Results:
Substantial evidence exists that reports an association between COVID-19 infection and cognitive decline. The studies included in this literature review surveyed distinct populations and reported cognitive deficits in COVID-19 patients as measured by a reduction in MoCA scores. While cognitive deficits were identified as partially reversible, there were still measurable deficits in cognition post-recovery compared to healthy controls. Furthermore, the measured cognitive deficits were found to be much worse in the geriatric population.
Conclusions:
Current literature shows an association between COVID-19 infection and the development of cognitive deficits. Further research should seek to characterize these cognitive deficits and determine the underlying aetiology and pathogenesis. Initiatives to develop interventions to limit or improve cognitive deficits in post COVID-19 patients is crucial, especially the elderly, given the large burden of disease within this population cohort.
... Growing scientific evidence suggests that different interventions and exercise modalities have benefits on the health and well-being of older adults, improving physical capacities, metabolic variables, depression, anxiety as well as cognitive function, both in normal states of brain aging and in different stages of cognitive impairment [12][13][14][15][16][17][18][19][20][21]. In particular, it has been suggested that although routine exercise generates physiological brain adaptations, when instructional methods challenge the ability to think and promote different movements, cognitive function is improved and maintained more efficiently [22]; this is typical of interventions based on dance and choreographic activities involving balance and coordination, which have been associated with positive effects on cognition [23], specifically by improving functional connectivity, cognitive performance and increasing brain volumes in the elderly [24]. ...
Growing evidence suggests that rhythmic physical activity (PA) improves cognitive function in both persons with normal brain aging and with cognitive impairment. This study aims to conduct a systematic review of randomized controlled trials assessing the effects of rhythmic PA over global cognition in older adults with and without mild cognitive impairment. Different keywords related to the topic and Boolean operators were used in the Web of Science, PubMed, and Scopus databases. A total of 11 articles that met the inclusion criteria were analyzed; all of them assessed global cognition using either the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA) or the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Five studies showed beneficial effects over global cognition. All studies had at least one experimental group with rhythmic training, and the interventions evidenced a great diversity of rhythmic stimuli, as well as a varied frequency, duration and type of activities. The heterogeneity of the protocols could be the reason for the mixed findings. Future studies with more precise exercise prescriptions are needed to establish whether rhythmic PA has beneficial effects on global cognition.
... The effect of exercise on cognitive performance in younger people shows positive changes in cognitive performance with low to moderate impacts [37]. Whereas in adults and the elderly, acute exercise training improves cognitive performance, as well as the elderly living in the community, and physical and recreational exercise, can significantly improve cognitive function and quality of life [24]. ...
... The benefits of exercise can be enhanced if combined with DT cognitive exercises in the domains of executive function, attention, memory, information processing, and reaction time. These components are related to gait and balance and, of course, to the risk of falling [47][48][49][50]. Motor performance in functional tests reduces the chances of falling when at adequate levels [51]. ...
Background
The risk of falling increases with neuromusculoskeletal and cognitive changes resulting from aging. Physical exercise shows beneficial effects on the risk of falling, but the results are unknown when associated with cognitive activity dual-task (DT)
Objective
The objective of the study was to evaluate the impacts of the Otago Exercise Program (OEP) plus DT cognitive activity on the risk of falling in older adults.
Method
36 older adults (83.5±5.7 years) participated in a quasi-experimental study, distributed in two experimental groups and a control group: 1) OEP (OEPG; n=12), 2) OEP plus DT (OEPDTG; n=12), and a control group (CG; n=12). Older adults were evaluated at pre- and post-12 weeks of intervention-. The thresholds for the risk of falling were considered as multiparameter scores of the 10 Meter Walking Test (10MWT), evocative 10MWT, Timed Up and Go (TUG), Sit to Stand Test (STS), and The Four-Stage Balance Test (Four-Stage), and the Montreal Cognitive Assessment (MoCA), to test the cognitive impairment.
Results
At baseline, all groups were homogeneous. Post-intervention, the experimental groups presented significant functional differences, in comparison to the CG, for 10MWT (OEPDTG: p=0.002; OEPG: p=0.002); evocative 10MWT (OEPDTG: p=0.001; OEPG: p=0.001); TUG (OEPDTG: p=0.034); STS (OEPDTG: p<0.001; OEPG: p<0.001) and cognitive for MoCA (OEPDTG: p<0.019). Significant intra-group differences (pre-post) were observed in all intervention groups, but none in CG. The risk of falling (Four-Stage) in experimental groups (OEPDTG: 33.3%; OEPG: 41.7%) was considerably lower than CG (83.3%).
Conclusion
Otago Exercise Program alone can reduce the risk of falling due to improved functionality, but adding the dual task also improves cognitive capacity in older adults. The clinical significance of these interventions goes beyond statistics.
... As we all know, exercise is beneficial to the treatment of many neurodegenerative diseases and mood disorders. Accumulative studies showed that exercise can improve brain function in many ways such as neurotransmitter release, neurotrophic factors and neurogenesis, and changes in cerebral blood flow (Bherer, 2015;Mikkelsen et al., 2017). METH can induce blood-brain barrier damage and oxidative stress, which lead to behavioral abnormality in the mice . ...
Anxiety-like symptoms are common symptoms of methamphetamine (METH) users, especially in the acute withdrawal period, which is an important factor for the high relapse rate during METH acute withdrawal. Exercise has been demonstrated to relieve anxiety-like symptoms during METH withdrawal, but the underlying mechanisms of this anti-anxiety effect are still unclear. Activated microglia and abnormal neuroinflammation play an important role in the pathogenesis of anxiety-like symptoms after METH withdrawal. Moreover, peripheral immune factors were also significantly associated with anxiety symptoms. However, the effects of treadmill exercise on microglial function and neuroinflammation in the striatum and hippocampus during acute METH withdrawal have not been reported. In the current study, we found severe peripheral immune dysfunction in METH users during acute withdrawal, which may in part contribute to anxiety symptoms during METH acute withdrawal. We also showed that 2 weeks of METH exposure induced anxiety-like symptoms in the acute withdrawal period. Additionally, METH exposure resulted in increased microglial activation and proinflammatory cytokines released in the mouse striatum and hippocampus during acute withdrawal. We next evaluated the effects of treadmill exercise in countering anxiety-like symptoms induced by METH acute withdrawal. The results showed that anxiety-like symptoms induced by acute METH withdrawal were attenuated by coadministration of treadmill exercise. In addition, treadmill exercise counteracted METH-induced microglial activation in the mouse striatum and various subregions of the hippocampus. Furthermore, treadmill exercise also reversed the increase in proinflammatory cytokines induced by acute METH withdrawal in the mouse striatum, hippocampus and serum. Our findings suggest that the anti-anxiety effect of treadmill exercise may be mediated by reducing microglial activation and regulating central and peripheral inflammatory responses.
... Regarding the kind of exercise intervention more recommended to this population, recent systematic reviews and meta-analyses (Karssemeijer et al., 2017;Bruderer-Hofstetter et al., 2018;Gheysen et al., 2018;Gavelin et al., 2021) concluded that dual-task or multicomponent exercise is more advantageous than a simple exercise in MCI individuals, since working simultaneously on the physical and cognitive components allows for more stimuli, enhancing neural regeneration by increasing blood flow to the brain, promoting neural growth, maintaining brain function, and improving brain plasticity (Bherer, 2015;Morita et al., 2018). Combining physical and cognitive rehabilitation programs leads to significant improvements in physical fitness and also improves cognitive performance (Karssemeijer et al., 2017;Bruderer-Hofstetter et al., 2018;Gheysen et al., 2018;Zhang et al., 2019;Gavelin et al., 2021). ...
Regular exercise has been shown to be one of the most important lifestyle influences on improving functional performance, and decreasing morbidity and all-cause mortality among older people. However, although there is some evidence on the effects of aerobic training on oxidative stress, there is little information regarding the effects of multicomponent exercise (dual-task training) and combination of exercise with cognitive stimulation on oxidative stress. In this context, the aim of this study was to verify the effects of a multicomponent exercise program on physical fitness and cognitive function in the elderly with mild cognitive impairment and determine the role of oxidative stress and brain-derived neurotrophic factor (BDNF). At baseline, 37 elderly nursing home residents with mild cognitive impairment were divided into two groups: the control group (CG, n = 12, 81.8 years) and the experimental group (EG, n = 25, 83.2 years). These elderlies followed multicomponent exercise training for 24 weeks, with two sessions per week and 45–50 min per session. The exercises included both aerobic and strength exercises, considering functional movements and light to moderate intensity. Cognitive stimulation comprehended exercises based on word games, puzzles, mathematical calculations, forward and backward counting, computer exercises, exergames, and games on a balanced platform. Physical assessments (weight, height, and body mass index), health and functional parameters (fitness tests: chair stand, arm curls, chair sit-and-reach, eight feet up-and-go, back scratch, 6-min walking, feet together, semi-tandem, and full tandem), lipid profile (total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides), measures of lipid peroxidation damage, thiobarbituric acid reactive substances (TBARS), total antioxidant capacity (TAC), and BDNF were measured in plasma, based on which analyses were performed before and after the 24 weeks of the multicomponent exercise intervention. The results showed an overall improvement in physical and functional performance. Regarding biochemical measures, multicomponent exercises lead to a significant decrease in oxidative damage. The results indicate that multicomponent exercise training induces benefits in functional capacity and reduces damage due to oxidative stress.
... • "Combined/sequential" interventions, wherein the components are administered sequentially/in tandem [23,28,[62][63][64][65]; • "Dual-task/multicomponent" interventions, wherein components are administered simultaneously, but are typically separate tasks (e.g., reciting numbers backwards while walking) [66][67][68][69][70][71][72][73], which can be further contrasted with; • Interactive interventions, as in exergaming, in which the actions in one realm affect the other (e.g., pedaling and steering controls progress in a virtual world and attainment of goals) [61,[74][75][76][77][78]; • According to these authors, a second decision must be considered in our decision tree, i.e., sequential, dual task/multicomponent, or interactive intervention ( Figure 2). The recent literature has considered that dual task or multicomponent exercise is more advantageous than simple exercise in this population since working simultaneously on the physical and cognitive components allows for more stimuli while enhancing neural regeneration by increasing blood flow to the brain, promoting neural growth, maintaining brain function, and improving brain plasticity [46,49]. ...
Dementia patients are at high risk for the decline of both physical and cognitive capacities, resulting in an increased risk of the loss of autonomy. Exercise is regarded as a non-pharmacological therapy for dementia, considering the potential benefits of preventing cognitive decline and improving physical fitness. In this paper, we aim to describe the different design stages for an exercise program combined with cognitive stimulation for a population with mild cognitive impairment, i.e., the MEMO_MOVE program.
Methods:
The intervention design followed the Medical Research Council's guidelines for complex interventions and was structured according to the six steps in quality intervention development (6SQuID). The intervention was described considering the Template for Intervention Description and Replication (TIDieR). In order to establish the intervention characteristics, a literature review was conducted to collate and analyze previous work, which provided a summary the type of exercise that should be implemented among this population.
Results:
The MEMO_MOVE program was structured and described, regarding (i) inclusion of a cognitive stimulation component; (ii) the kind of cognitive stimulation; and (iii) the type of exercise, duration, frequency, intensity, and program length.
Conclusions:
A systematic step-by-step process design was followed to create a specific intervention to promote physical fitness and cognitive stimulation in individuals with mild dementia.
... For example, the concept of positive ageing may involve artistic creativity and positive literacy practices, affording opportunities for personal development, reinvigoration, engaging in meaningful activities and developing strong human connections (Addams- Price, 1998;Gergen & Gergen, 2001). Creative engagement and output, including creative writing, also offers the possibility to maintain brain plasticity for older people (Bherer, 2015;D. C. Park & Bischof, 2013). ...
Compared with other age groups, the literacy practices and creative outputs of older adults (50+ years) have been seldom researched. Generally, research about older adults has tended to focus on decline and agential passivity, rather than potentiality. In this article, we report on a small ethnographic study of older Australians who were part of a University of the Third Age (U3A) poetry group in Melbourne, Australia. We examine the literacy practices of the group in writing poetry, especially focusing on the triggers for poetry ideas and the beginning processes of poetry writing. The reported research centres on a session of the group conducted online in 2020. Employing ideas from David Hume, particularly his notion of the empirical basis for the development of concepts, as well as the idea of dialogism from Mikhail Bakhtin, the transcript of the focus group was analysed using themes that the participants discussed. Results suggest that the older adults in the study employed sensory images together with imagination, life memories and feeling states to create and form highly individual poetry of significance to their lives in the context of the positive rapport and dialogic engagement that developed within the poetry group.
... There is sufficient evidence of the effects of cognitive training on outcomes such as neuroplastic changes in the brain assessed by neuroimaging [29], patient self-esteem [30] or executive function [31]. The effects are larger for task-specific skills, that is, if the exercise closely matches the target real-life task [32,33]. Cognitive training can enhance the management of the tasks that are relevant for participation in everyday life. ...
Background
Combining smartphone-assisted group activities in the neighbourhood and training in physical and cognitive skills may offer the potential to promote social participation and connectedness of older adults. This non-controlled proof-of-concept, retrospectively registered study aimed to determine the feasibility of such an intervention approach, including its evaluation.
Methods
In two consecutive six-month intervention cycles, 39 community-dwelling adults were provided with weekly smartphone, physical and cognitive training by two tutors. Using a specifically designed app, the participants were also encouraged to join and later self-organise physically and cognitively stimulating activities related to hot spots in their Bochum neighbourhood. Indicators of feasibility were documented.
Results
The recruitment and assessments took 3 hours per participant. Excluding smartphone support, the preparation and the implementation of the intervention amounted to nine person-hours per week.
Six participants dropped out, and 13 did not complete one or more assessments. The participants attended 76 ± 15% of the weekly training sessions. The instructors deemed the programme feasible, but familiarisation with the smartphone and the app was very time-consuming.
Twenty-seven of 29 participants reported high overall satisfaction, and 22 agreed that the programme helped them to establish social contacts. The smartphones attracted substantial interest and were used frequently, despite mixed satisfaction with the project-specific app. From baseline to follow-up, the six-minute walking distance, lower extremity strength and moderate to vigorous physical activity, as well as quality of life, were preserved at a high level, while balance performance was significantly improved. Of the 11 tests related to cognitive functioning, 4 tests (a memory test, the Stroop test and 2 tests of verbal fluency) indicated significant improvement. No moderate or serious adverse events occurred in relation to the assessments or the intervention.
Conclusions
The multimodal approach seems safe and feasible and offers the potential to promote social connectedness, bonds in the residential neighbourhood and smartphone competency, as well as to preserve or improve physical and cognitive functions. Adaptations of the intervention and of the outcome assessments may contribute to better assessment and exploitation of the potential of this approach in a future study involving socially, physically and cognitively less active elderly persons.
... Physical activity (PA) as well as a healthy diet and cognitive training are protective factors that can help prevent or delay dementia (Ahlskog et al., 2011;Baumgart et al., 2015). In this sense, PA acts on the brain, promoting brain neuroplasticity and resistance to brain ageing (Ahlskog et al., 2011;Bherer, 2015;Scarmeas et al., 2011;Stephen et al., 2017). In this regard, a recent meta-analysis concluded that doing one hour of PA twice a week reduces the risk of dementia (Lee, 2018). ...
Objective:
The aim of this study was to analyse the relationship between physical activity and the incidence of dementia in a cohort of people aged 50 years or older without dementia from different countries in Europe between the years 2013 and 2015.
Methods:
Prospective longitudinal design study (2013-2015) with a sample of 46,141 people without dementia in 2013 who participated in the SHARE project in waves 5 and 6, where 15 European countries participated. We defined dementia as a self-report of Alzheimer's disease, organic brain syndrome, senility, or any other serious memory impairment during follow-up. The frequency of moderate, vigorous and moderate-to-vigorous physical activity in 2013 was obtained from a validated questionnaire. Incidences of dementia by year (between 2013 and 2015) were calculated for each category of physical activity. Poisson regression models with robust variance were fitted for the association between physical activity and dementia.
Results:
The incidence of dementia was 7.4 [95%CI = 6.8-7.9] cases per 1000 persons per year. Very frequent moderate physical activity is a protective factor for dementia independently of the frequency of vigorous physical activity and inversely. The risk of dementia was 2.36 [95%CI = 1.77-3.14] higher in people who hardly ever, or never did moderate-to-vigorous physical activity comparing to people engaged in it more than once a week independently of the baseline cognitive level.
Conclusion:
Physical activity is associated with the incidence of dementia in people aged 50 and over in both men and women in Europe.
... increasing BDNF) are limited in time and return to baseline 10−60 min after the physical activity (Knaepen et al., 2010). This might explain why simultaneous CMDT interventions were found more effective than sequential interventions for cognitively healthy older adults (Tait et al., 2017), inducing synergistic cognitive effects (Fissler et al., 2013) and affecting neuroplasticity additively (Bamidis et al., 2014;Bherer, 2015). ...
Le vieillissement entraîne un déclin des capacités cognitives, motrices, et à réaliser deux tâches simultanément (doubles tâches). Ces altérations peuvent augmenter les risques de chutes, la perte d’autonomie, voire la dégradation de la qualité de vie. Dans ce contexte, nous savons que les entraînements en doubles tâches sont efficaces pour maintenir ces fonctions. Le passage par le jeu dans les programmes d’entraînement (exergames) permet de motiver les participants et de maintenir leur engagement. L’objectif de notre travail était de concevoir, développer et évaluer l’efficacité d’un exergame personnalisé reposant sur le concept de l’interférence cognitivo-motrice auprès de séniors. Après avoir mesuré l’intensité de la sollicitation physique de cet exergame, nous avons évalué son efficacité à court et moyen terme pour l’amélioration des capacités cognitives, motrices et de doubles tâches chez des personnes âgées. Nous avons également mesuré l’impact de cet entraînement sur le niveau d’activité physique, la motivation, la peur de tomber et la qualité de vie des participants. Enfin, nous avons étudié le niveau de sécurité et d’adhérence de ce jeu. Nous avons ainsi montré que notre exergame était fonctionnel, utilisable comme support d’entraînement, sûr et apprécié par tous ses utilisateurs (participants comme animateurs). Nous avons également montré que cet exergame d’intensité modérée entrainait une amélioration des fonctions cognitives et un maintien des fonctions motrices des séniors. Ce projet répond aux enjeux actuels de meilleure compréhension de l’efficacité des exergames personnalisés et ouvre de nouvelles perspectives sur cette thématique.
... The present paper, written as a brief overview, 1 takes a focused approach in evaluating the individual and combined effects of two specific intrapersonal-related factors on cognitive function. 2 Specifically, this overview evaluates the individual and combined effects of cognitive training and physical exercise (training) on cognitive performance. Of specific interest is whether these two types of training (cognitive and physical) have an additive effect on cognition that is greater than their individual effects. ...
Objective: To provide a brief overview of the literature evaluating the individual and combined effects of cognitive and physical (exercise) training on cognitive function. Design and Methods: An overview review approach was employed. Results: Cognitive and physical training, and their combination, can improve various cognitive outcomes (e.g., memory) in several adult populations (e.g., healthy older adults, older adults with mild cognitive impairment). These effects, howev er, are influenced by several factors, such as the setting in which the training occurs (e.g., supervised or home-based), the type of combined training (e.g., physical-cognitive, motor-cognitive, multi-domain), and the type of comparison/con trol group utilized. Conclusions: Combining cognitive and physical exercise together in a training program may yield improvements in cogni tive function.
... Thus, individuals who work at an older age may experience the beneficial effects of physical activity. Furthermore, physical activities enhance the cognitive functions of older adults (71)(72)(73). ...
This study aimed to validate the Persian version of the Lifetime of Experiences Questionnaire (LEQ) and examine the relationship between life experience and memory function. To this end, two studies were conducted. Study one examined the factor structure, internal consistency, and convergent and discriminant validity of the Persian version of LEQ with 247 healthy elderly individuals (M age = 70.17, SD = 4.42; 55.9% women). The exploratory factor analysis yielded a five-factor solution, including Knowledge, Physical, Socialization, Artistic, and Leisure dimensions, which accounted for 42.42% of the explained variance. The internal consistency of the LEQ was in the acceptable range (α = 0.703). Also, the LEQ and its subscales (except the Artistic subscale) had a negative relationship with geriatric depression and a positive relationship with a healthy lifestyle, supporting the measure's convergent and discriminant validity. In the second study, we examined the relationship between LEQ (total and subscales score) and memory function using Pearson correlation and moderating analysis with 149 participants (M age = 70.37, SD = 4.29; 55.03% women). The results demonstrated that the LEQ total and subscales scores correlated positively with episodic memory. In the same vein, LEQ total score and Knowledge subscale showed a positive correlation with semantic memory. The results of moderation analysis showed that LEQ subscales have a different role in memory decline. The knowledge subscale as a content component moderates the effect of age on semantic memory (B = 0.005, t = 2.021, p = 0.045), while the mid-life non-specific activities, which are based on life stages, moderate the effect of age on episodic memory (B = 0.007, t = 3.348, p = 0.001). In conclusion, our results indicated that the Persian version of the LEQ is a valid and reliable instrument for measuring experiences and activities throughout life, which can be used in professional clinical and research settings in the aging context with Iranian elderly samples. Furthermore, our findings suggest that various life experiences can be considered cognitive reserves in old age.
As clinical psychologists working with older adults, we are all likely familiar with the above question, both in memory services and those who do not have a diagnosed cognitive problem. In the context of an ageing population, much research has been focused on the development of cognitive training as an intervention to promote healthy ageing. Defining what it means to age healthily, however, can be problematic, particularly given the heterogeneity evidenced in studies of normative cognitive functioning in older people. Furthermore, although different cognitive training methods appear to have face value, the evidence base for the effectiveness of cognitive training is mixed, and has, to date, provided conflicting results. This article discusses the findings of major research studies in this area, and possible future directions of research are considered.
Objectives
Parkinson’s disease (PD) is a neurodegenerative disorder that impacts the dopaminergic neurons of the substantia nigra, leading to motor and non-motor symptoms, as well as changes in activities of daily living (ADL) and quality of life (QoL). Aquatic physical exercises and dual-task physical exercises have been used to manage PD symptoms. The aim of this study was to investigate the effects of a dual-task aquatic exercise program on the ADL, motor symptoms, and QoL of individuals with PD.
Methods
A randomized controlled trial with a parallel group design was employed, and participants were randomized into 2 groups: a control group and an experimental group. The intervention was a 10-week program consisting of twice-weekly 40-minute aquatic dual-task exercises. Pre-intervention evaluations of ADL, motor function, and QoL were conducted at baseline (AS1), immediately after the intervention (AS2), and 3 months post-intervention (follow-up—AS3). The Unified Parkinson’s Disease Rating Scale (UPDRS) II and III sections and the Parkinson’s Disease Questionnaire 39 (PDQ-39) were utilized for outcome measures.
Results
A total of 25 individuals completed the study. The experimental group showed significant improvements in both the UPDRS II (ADL) and III (motor function) sections ( P’s < .05), but there was no significant difference in PDQ-39 scores. Additionally, significant differences were observed in the experimental group between the AS2 and AS3 time periods ( P < .05) for both UPDRS II and III scores ( P < .05).
Conclusions
Aquatic dual-task training may be effective in improving both ADL and motor functions in individuals with PD. Furthermore, the combination of aquatic environment and dual-task exercises may represent a promising approach to maintaining and improving the functionality of individuals with PD.
This study aimed to investigate the effects of a beauty program on the self-perception of aging and depression among the community-dwelling older adults in an agricultural area in Taiwan. Twenty-nine older adults aged 65 and above in one agricultural community care center completed the program. Based on cosmetic therapy, the beauty program consisted of 13 sessions focused on facial skin care, make-up application, and massage with essential oils. Each 90 min session of the program was conducted in groups once a week for 13 weeks. This study applied the mixed methods approach, and data were gathered through questionnaire surveys, interviews, and observation. Before and after the beauty program, the elderly individuals’ self-perceptions of aging and depression were assessed using the Attitudes towards Old People Scale (ATOPS) and Taiwanese Depression Questionnaire (TDQ), respectively. The participants’ ATOPS scores after the program were significantly higher than those examined before the program (p < 0.001), and their TDQ scores were significantly lower than those before the program (p < 0.001). Additionally, the participants’ body images were improved, the participants disrupted their stereotypes about makeup, and they were willing to gradually maintain their appearance. Overall, the beauty program was effective for enhancing the self-perceptions of aging and reducing depression in older adults in rural Taiwan. Further research with a larger population of older individuals, male older adults, or frail older adults is needed to examine the specific effects of the beauty program.
Intrinsic capacity is central to the maintenance of function in older adults, and maintaining optimal intrinsic capacity is of great importance to promote healthy aging. The purpose of this systematic review and meta-analysis was to analyze the impact of multi-domain interventions on intrinsic capacity in older adults, intervention components, and potential interactions between components. A total of 6740 published articles were screened until August 2022, and the review included 25 randomized controlled trials that analyzed populations, interventions, control groups, and outcomes. The meta-analysis showed improvements in the primary outcome indicators in the intervention group compared to the control group. These included increased scores on the Mini-Mental State Examination as an indicator of cognitive function, decreased scores on the Geriatric Depression Scale (GDS-15) as an indicator of psychological ability and increased scores on the Short Physical Performance Battery (SPPB) as an indicator of physical performance, with only the SPPB indicator analyzed showing greater heterogeneity. Significant improvements were also seen in the secondary indicators Time-to-Walk Test (TUG), gait speed, Chair Stand Test (CST), grip strength values and BMI. There was insufficient data for the Mini Nutritional Assessment (MNA) as an indicator of vitality to conduct a meta-analysis. Studies were of moderate to high quality. The results of this review indicate that multi-domain interventions can maintain the level of intrinsic capacity in older adults and are equally effective in older adults with declining self-care abilities.
This study aims to examine the effects of 12 weeks of physical-cognitive dual-task training on cognition, depression, sleep quality, and quality of life in older women (n = 44; 66.20 ± 4.05 years). Of these, 22 were randomly allocated to the dual-task training (DT) group, and 22 participated in the activities of the education control group (CG). Assessments were performed at baseline, at the end of 12 weeks of intervention, and after 12 weeks of follow-up using the following instruments: Trail Making Test parts A and B, ΔTMT (B-A), Stroop test parts A, B, C, and ΔStroop (C-B), Geriatric Depression Scale (GDS), sleep quality (PSQI), quality of life (SF-36). The results showed a positive and significant time-group interaction for two cognitive domains (TMT and Stroop). No time-group interaction effect was indicated for depression and sleep quality perception. There was a positive and significant interaction effect between time and group for three SF-36 subcategories (physical function, physical role, and general health). Our training protocol was not able to improve depressive symptoms and sleep quality. On the other hand, DT training was able to promote the performance of executive functions and the physical and mental component summary of the quality of life with lasting effects of up to 12 weeks after the intervention.
Physical exercise has been considered to be an efficient mean of preserving cognitive function and it influences both the structural and functional characteristics of the brain. It has especially been shown to increase brain plasticity, the capacity to re-structure brain properties in response to interaction, such as cognitive practice. Studies have also examined the potential additive effect of cognitive training on the documented benefit of physical exercise, commonly, however, not at the neural level. We monitored, using magnetoencephalography (MEG), the brain processes associated with executive functions in older individuals who participated in a 12-month randomized controlled trial including two research arms: physical and cognitive training vs physical training alone. Measurements were conducted at 0 months, 6 months, and 12 months. The addition of cognitive training was associated with better performance in the Stroop test that reflects executive control. The extra benefit of cognitive training was also manifested as decreased modulation of beta frequency band (15–25 Hz) especially to difficult distractors. As beta band activity is associated with attentional control, this indicates fewer resources needed to inhibit irrelevant sensory inputs. These results imply an enhancing role of cognitive elements integrated with physical training in improving or maintaining executive functions in older individuals.
Objective:
To explore the effects of rhythmic movement interventions on the physical and cognitive functions among cognitively healthy older adults.
Methods:
We searched PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, CBM, Wanfang Data, and VIP databases from inception to March 30, 2022. The inclusion criteria were: ① randomized controlled trials (RCTs); ② older adults (aged ≥ 60 years) without cognitive impairments or neurological or neurodegenerative diseases; ③ intervention: rhythmic movement (rhythmic exercise or physical activities performed to music); ④ outcomes: physical or cognitive function. Overall, 44 RCTs across 20 countries (n = 2752 participants) were included.
Results:
An association was found between rhythmic movement and improved physical function (mobility, cardiopulmonary endurance, muscle strength, flexibility, and balance), global cognitive function, and quality of life (QOL). The physical function outcomes suggested additional significant benefits when using control groups with no exercise than when using control groups with exercise. No significant improvement was found in executive function.
Conclusion:
Regular rhythmic movement likely improves physical function, global cognitive function, and QOL in healthy older adults. The effect of rhythmic movement on the physical function in older adults is similar to that of routine exercise. Further studies on cognitive function of healthy older adults using larger samples of populations with more balanced sex ratios with long-term follow-up are particularly encouraged.
Aim: To explore the effectiveness of home-based exercise programs with e-devices (HEPEs) on falls among community-dwelling older adults. Methods: Twelve randomized controlled trials were included in the meta-analysis considering four fall-related outcomes. Results: HEPEs significantly reduced the rate of falls (risk ratio: 0.82; 95% CI: 0.72-0.95; p = 0.006) and improved lower extremity strength (mean difference: -0.94; 95% CI: -1.71 to -0.47; p < 0.001). There was a significant improvement favoring HEPEs on balance if the participants were aged >75 years (mean difference: -0.55; 95% CI: -1.05 to -0.05; p = 0.03), or the intervention duration was at least 16 weeks (mean difference: -0.81; 95% CI: -1.58 to -0.05; p = 0.04). Conclusion: HEPEs demonstrated an overall positive effect on falls among community-dwelling older adults.
Treatment of myelopathies, a vastly inclusive term referring to neurologic changes related to spinal cord dysfunction, requires both etiology specific and deficit specific interventions, as the initial damage to the spinal cord frequently results into long standing neurologic deficits. Over the past 1.5 decades, there has been a paradigm shift in the field of neuro-rehabilitation, moving the focus from compensation to restoration in order to achieve functional goals. This shift was prompted by ever accruing evidence that the nervous system is capable of plastic changes and repair and the process is activity dependent. Activity based restorative therapy (ABRT) is defined as a life-long intervention where changes in the nervous and muscular system are driven by repetitive activation of the neuromuscular system above and below injury level. ABRT addresses impairments, activity and participation as defined by the Classification of Functioning, Disability and Health (ICF), the World Health Organization’s (WHO) framework designed to measure health and disability at both individual and population levels. Key components of ABRT are: (1) Functional Electrical Stimulation (FES); (2) Locomotor Gait Training (LT); (3) Weight Loading/Bearing; (4) Massed Practice and (5) Task-Specific Practice. While much remains to be studied regarding the application and benefits of utilizing an activity based restorative rehabilitation program when addressing consequences related to neurologic insults like those induced by myelopathies, the substantial knowledge supporting activity dependent neuro-plasticity behooves re-structuring the traditional approach to change neurologic and day to day function, moving firmly from compensation to restoration.KeywordsActivity dependent restorative therapy (ABRT)MyelopathyExerciseFunctionNeuro-plasticity
The aim of this study was to examine the association between physical functioning and cardiovascular burden on the cognitive performance of community-dwelling older adults.
Ninety-three adults aged 60 and older completed a medical evaluation by a geriatrician, performance-based physical tests, and neuropsychological assessments. Cognitive composite scores (memory, speed, and executive) as well as a physical functioning score were created by averaging standardized z-scores of selected tests. A cardiovascular burden index was also computed by totalling the number of cardiovascular risk factors and diseases.
Multiple hierarchical regression analyses reveal that higher level of physical functioning was significantly associated with greater processing speed and better executive functions but was not associated with memory performance. These relations were independent of age, sex, and level of education. Cardiovascular burden was not significantly associated with any cognitive domain.
These results suggest that cognition is related to simple performance-based physical tests and highlight the importance of intervention studies aimed at enhancing cognitive and physical functioning in older adults.
Studies supporting the notion that physical activity and exercise can help alleviate the negative impact of age on the body and the mind abound. This literature review provides an overview of important findings in this fast growing research domain. Results from cross-sectional, longitudinal, and intervention studies with healthy older adults, frail patients, and persons suffering from mild cognitive impairment and dementia are reviewed and discussed. Together these finding suggest that physical exercise is a promising nonpharmaceutical intervention to prevent age-related cognitive decline and neurodegenerative diseases.
An increasing number of studies have relied on brain imaging to assess the effects of cognitive training in healthy aging populations and in persons with early Alzheimer's disease or mild cognitive impairment (MCI). At the structural level, cognitive training in healthy aging individuals has been associated with increased brain volume, cortical thickness, and density and coherence of white matter tracts. At the functional level, task-related brain activation (using fMRI and PET) and fluorodeoxyglucose positron emission tomography (FDG-PET) were found to be sensitive to the effects of training. In persons with MCI, cognitive training increased brain metabolism and task-related brain activation, whereas healthy older adults showed patterns of increased and decreased activation. Further studies are required to generalize these findings to larger groups and to investigate more diverse training protocols. Research will also need to address important methodological issues regarding the use of biomarkers in cognitive aging, including reliability, clinical validity, and relevance to the pathophysiological process.
Growing evidence supports the use of physical training interventions to improve both physical and cognitive performances in healthy older adults. Few studies have examined the impact of aerobic exercise on Stroop task performance, a measure of executive functions. In the current 3-month aerobic training study, 50 older adults (mean age = 67.96 ± 6.25 years) were randomly assigned to either a three-month physical training group or to a control group (waiting list). Training sessions were 3 times per week for 60 minutes. All participants completed pre- and post-test measures of cognitive performance using the modified Stroop task and physical performance (Rockport one-mile test). Compared to controls, the training group showed significant improvements in physical capacity (P < 0.001) and enhanced Stroop performance, but only in the inhibition/switching condition (P < 0.03). Furthermore, the increase in aerobic capacity induced by the training regimen correlated negatively with reaction time in the inhibition/switching condition of the Stroop task at posttest (r = -0.538; P = 0.007). Importantly, the reported gains in cognitive performance were observed after only three months of physical training. Taken together, the results suggest that even short-term physical interventions can enhance older adults' executive functions.
Objectives:
Frailty is a state of vulnerability associated with increased risks of fall, hospitalization, cognitive deficits, and psychological distress. Studies with healthy senior suggest that physical exercise can help improve cognition and quality of life. Whether frail older adults can show such benefits remains to be documented.
Method:
A total of 83 participants aged 61-89 years were assigned to an exercise-training group (3 times a week for 12 weeks) or a control group (waiting list). Frailty was determined by a complete geriatric examination using specific criteria. Pre- and post-test measures assessed physical capacity, cognitive performance, and quality of life.
Results:
Compared with controls, the intervention group showed significant improvement in physical capacity (functional capacities and physical endurance), cognitive performance (executive functions, processing speed, and working memory), and quality of life (global quality of life, leisure activities, physical capacity, social/family relationships, and physical health). Benefits were overall equivalent between frail and nonfrail participants.
Discussion:
Physical exercise training leads to improved cognitive functioning and psychological well-being in frail older adults.
It has been shown that dual-task training leads to significant improvement in dual-task performance in younger and older adults. However, the extent to which training benefits to untrained tasks requires further investigation. The present study assessed (a) whether dual-task training leads to cross-modality transfer in untrained tasks using new stimuli and/or motor responses modalities, (b) whether transfer effects are related to improved ability to prepare and maintain multiple task-set and/or enhanced response coordination, (c) whether there are age-related differences in transfer effects. Twenty-three younger and 23 older adults were randomly assigned to dual-task training or control conditions. All participants were assessed before and after training on three dual-task transfer conditions; (1) stimulus modality transfer (2) response modality transfer (3) stimulus and response modalities transfer task. Training group showed larger improvement than the control group in the three transfer dual-task conditions, which suggests that training leads to more than specific learning of stimuli/response associations. Attentional costs analyses showed that training led to improved dual-task cost, only in conditions that involved new stimuli or response modalities, but not both. Moreover, training did not lead to a reduced task-set cost in the transfer conditions, which suggests some limitations in transfer effects that can be expected. Overall, the present study supports the notion that cognitive plasticity for attentional control is preserved in late adulthood.
The hippocampus shrinks in late adulthood, leading to impaired memory and increased risk for dementia. Hippocampal and medial temporal lobe volumes are larger in higher-fit adults, and physical activity training increases hippocampal perfusion, but the extent to which aerobic exercise training can modify hippocampal volume in late adulthood remains unknown. Here we show, in a randomized controlled trial with 120 older adults, that aerobic exercise training increases the size of the anterior hippocampus, leading to improvements in spatial memory. Exercise training increased hippocampal volume by 2%, effectively reversing age-related loss in volume by 1 to 2 y. We also demonstrate that increased hippocampal volume is associated with greater serum levels of BDNF, a mediator of neurogenesis in the dentate gyrus. Hippocampal volume declined in the control group, but higher preintervention fitness partially attenuated the decline, suggesting that fitness protects against volume loss. Caudate nucleus and thalamus volumes were unaffected by the intervention. These theoretically important findings indicate that aerobic exercise training is effective at reversing hippocampal volume loss in late adulthood, which is accompanied by improved memory function.
This study assessed the effects of an aerobic training program on reaction time tasks that manipulated preparatory intervals (PI) to produce temporal preparation effects using short (1, 3, 5 s) and long (5, 7, 9 s) PI. Older adults were assigned to either a 3-month aerobic training group or to a control group. Individuals in the training group participated in an aerobic training program of three 60-min sessions per week. The control group did not receive any training. Results indicated that 12 weeks of aerobic training induced a significant improvement in cardiorespiratory capacity (VO(2)max estimate). All participants who completed the aerobic program showed improvement after training in the choice RT task, along with enhanced preparation, such that they maintained preparation over time more efficiently after the training program. Moreover, enhanced ability to use the short PI was observed but only in lower fit individuals. Results of the present study suggest that improving aerobic fitness may enhance attentional control mechanisms in older adults.
There is growing evidence of the involvement of executive control in the maintenance of balance in old age. We examined whether healthy older adults who completed five sessions of nonmotor cognitive dual-task training would show significant improvements on measures of dual-task standing balance and mobility, compared with an untrained control group.
Twenty healthy older adults were assigned to either training or control groups. In the pre- and post-training sessions, all participants performed tests of cognition, balance, and mobility (single-support balance, dynamic posturography, sit-to-stand, 40-foot walk) under single- and dual-task conditions. The training group completed five sessions of cognitive dual-task training spaced at least 2 days apart. The two tasks involved making two-choice decisions to visually presented stimuli. Participants completed multiple blocks of single-task (task A or B, blockwise) and mixed (A, B, or A + B) trials in each training session.
The training group showed significant improvements in body sway during single-support balance and center of gravity alignment during double-support dynamic balance. The control group showed no appreciable improvements.
This study is the first to demonstrate training-related benefits to gross motor performance stemming from cognitive dual-task training. The results support the view that motor control in aging is influenced by executive control and have implications for theories of cognitive training and transfer.
The relationship between physical activity and cognitive function is intriguing but controversial. We performed a systematic meta-analysis of all the available prospective studies that investigated the association between physical activity and risk of cognitive decline in nondemented subjects.
We conducted an electronic literature search through MedLine, Embase, Google Scholar, Web of Science, The Cochrane Library and bibliographies of retrieved articles up to January 2010. Studies were included if they analysed prospectively the association between physical activity and cognitive decline in nondemented subjects.
After the review process, 15 prospective studies (12 cohorts) were included in the final analysis. These studies included 33,816 nondemented subjects followed for 1-12 years. A total of 3210 patients showed cognitive decline during the follow-up. The cumulative analysis for all the studies under a random-effects model showed that subjects who performed a high level of physical activity were significantly protected (-38%) against cognitive decline during the follow-up (hazard ratio (HR) 0.62, 95% confidence interval (CI) 0.54-0.70; P < 0.00001). Furthermore, even analysis of low-to-moderate level exercise also showed a significant protection (-35%) against cognitive impairment (HR 0.65, 95% CI 0.57-0.75; P < 0.00001).
This is the first meta-analysis to evaluate the role of physical activity on cognitive decline amongst nondemented subjects. The present results suggest a significant and consistent protection for all levels of physical activity against the occurrence of cognitive decline.
A number of studies have suggested that attentional control skills required to perform 2 tasks concurrently become impaired with age (A. A. Hartley, 1992; J. M. McDowd & R. J. Shaw, 2000). A. A. Hartley (2001) recently observed that the age-related differences in dual-task performance were larger when the 2 tasks required similar motor responses. The present study examined the extent to which age-related deficits in dual-task performance or time sharing--in particular, dual-task performance of 2 discrimination tasks with similar motor requirements--can be moderated by training. The results indicate that, even when the 2 tasks required similar motor responses, both older and younger adults could learn to perform the tasks faster and more accurately. Moreover, the improvement in performance generalized to new task combinations involving new stimuli. Therefore, it appears that training can substantially improve dual-task processing skills in older adults.
Older adults' difficulties in performing two tasks concurrently have been well documented (Kramer & Madden, 2008). It has been observed that the age-related differences in dual-task performance are larger when the two tasks require similar motor responses (2001) and that in some conditions older adults also show greater susceptibility than younger adults to input interference (Hein & Schubert, 2004). The authors recently observed that even when the two tasks require motor responses, both older and younger adults can learn to perform a visual discrimination task and an auditory discrimination task faster and more accurately (Bherer et al., 2005). In the present study, the authors extended this finding to a dual-task condition that involves two visual tasks requiring two motor responses. Older and younger adults completed a dual-task training program in which continuous individualized adaptive feedback was provided to enhance performance. The results indicate that, even with similar motor responses and two visual stimuli, both older and younger adults showed substantial gains in performance after training and that the improvement generalized to new task combinations involving new stimuli. These results suggest that dual-task skills can be substantially improved in older adults and that cognitive plasticity in attentional control is still possible in old age.
The availability of neuroimaging technology has spurred a marked increase in the human cognitive neuroscience literature, including the study of cognitive ageing. Although there is a growing consensus that the ageing brain retains considerable plasticity of function, currently measured primarily by means of functional MRI, it is less clear how age differences in brain activity relate to cognitive performance. The field is also hampered by the complexity of the ageing process itself and the large number of factors that are influenced by age. In this Review, current trends and unresolved issues in the cognitive neuroscience of ageing are discussed.
Glucose enhancing effects in older adults have mostly been observed for episodic memory, but have recently been found for attentional control performance. Yet, brain activation patterns underlying these effects are still unknown.
The present study examined the acute effects of glucose ingestion on prefrontal brain activation during the execution of a divided attention task in fasting non-diabetic older adults.
Twenty older adults (60 years and older) took part in the study that included two experimental sessions. After an overnight fast, participants received either a glucose drink (50 g) or a placebo (saccharin) drink, following which they completed a dual-task. During task execution, prefrontal activation was recorded with functional near-infrared spectroscopy (fNIRS). A repeated-measures design was used such that each participant served as his or her own control. The two experimental sessions were counterbalanced among participants and were performed two weeks apart.
When participants were in the glucose condition, they showed similar dual-task costs for both tasks, whereas in the placebo condition they prioritized one task over the other, with a significantly larger dual-task cost for the non-prioritized task (p<0.01). Differential brain activation was also observed in right ventral-lateral prefrontal regions for oxygenated hemoglobin and deoxygenated hemoglobin, with more activation apparent in the glucose condition (p<0.05). Furthermore, behavioral and activation data were influenced by individual differences in glucose regulation.
Glucose ingestion appears to momentarily enhance fasting seniors' capacity to coordinate more equally two concurrent tasks and this is reflected in brain activation patterns.
Cognitive deficits are frequent after coronary artery bypass graft surgery (CABG) in the elderly population. In fact, memory and attention deficits can persist several months after the surgery. Recent studies with healthy older adults have shown that memory and attention can be improved through cognitive training programs. The present study examined whether memory training (method of loci and story generation) and attentional training (dual-task computerized training) could improve cognitive functions in patients aged 65 years and older who underwent CABG surgery. Participants (n = 51) were assigned to one of three groups: (1) control group (tested at 1, 3 and 6 months after the surgery), (2) attention training followed by memory training, (3) memory training followed by attention training (groups 2 and 3: tested at 1, 2, 3 and 6 months after the surgery). The trainings took place between the 6th and 10th week following the surgery. The three groups were compared before and after each training program using attention and memory tests and neuropsychological tests. The results showed that attention and memory trainings lead to significant improvement in the cognitive domain that was trained. It thus seems that cognitive training can be a promising tool to enhance cognitive functions after a CABG surgery.
A meta-analytic study was conducted to examine the hypothesis that aerobic fitness training enhances the cognitive vitality of healthy but sedentary older adults. Eighteen intervention studies published between 1966 and 2001 were entered into the analysis. Several theoretically and practically important results were obtained. Most important fitness training was found to have robust but selective benefits for cognition, with the largest fitness-induced benefits occurring for executive-control processes. The magnitude of fitness effects on cognition was also moderated by a number of programmatic and methodological factors, including the length of the fitness-training intervention, the type of the intervention, the duration of training sessions, and the gender of the study participants. The results are discussed in terms of recent neuroscientific and psychological data that indicate cognitive and neural plasticity is maintained throughout the life span.
The extent to which cortical plasticity is retained in old age remains an understudied question, despite large social and scientific implications of such a result. Neuroimaging research reports individual differences in age-related activation, thereby educing speculation that some degree of plasticity may remain throughout life. We conducted a randomized longitudinal dual-task training study to investigate if performance improvements (a) change the magnitude or pattern of fMRI activation, thereby suggesting some plasticity retention in old age and (b) result in a reduction in asymmetry and an increase in age differences in fMRI activation as a compensatory model of performance-related activation predicts. Performance improvements were correlated with an increase in hemispheric asymmetry and a reduction in age differences in ventral and dorsal prefrontal activation. These results provide evidence for plasticity in old age and are discussed in relation to an alternative argument for the role of reduced asymmetry in performance improvements.
Laboratory based training studies suggest that older adults can benefit from training in tasks that tap control aspects of attention. This was further explored in the present study in which older and younger adults completed an adaptive and individualized dual-task training program. The testing-the-limits approach was used [Lindenberger, U., & Baltes, P. B. (1995). Testing-the-limits and experimental simulation: Two methods to explicate the role of learning in development. Human Development, 38, 349-360.] in order to gain insight into how attentional control can be improved in older adults. Results indicated substantial improvement in overlapping task performance in both younger and older participants suggesting the availability of cognitive plasticity in both age groups. Improvement was equivalent among age groups in response speed and performance variability but larger in response accuracy for older adults. The results suggest that time-sharing skills can be substantially improved in older adults.
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Georgia.
Amélioration des performances cognitives et de la qualité de vie suite à un programme d'entraînement physique chez une patiente sévèrement fragile
- Langlois F