Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia: A meta-analysis

Ageing Research Reviews, Journal Year: 2017, Volume and Issue: 40, P. 75 - 83

Published: Sept. 12, 2017

Language: Английский

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Screening for Cognitive Impairment in Older Adults

JAMA, Journal Year: 2020, Volume and Issue: 323(8), P. 764 - 764

Published: Feb. 25, 2020

Importance

Early identification of cognitive impairment may improve patient and caregiver health outcomes.

Objective

To systematically review the test accuracy screening instruments benefits harms interventions to treat in older adults (≥65 years) inform US Preventive Services Task Force.

Data Sources

MEDLINE, PubMed, PsycINFO, Cochrane Central Register Controlled Trials through January 2019, with literature surveillance November 22, 2019.

Study Selection

Fair- good-quality English-language studies instruments, pharmacologic nonpharmacologic treatments aimed at persons mild (MCI), moderate dementia, or their caregivers. Extraction Synthesis Independent critical appraisal data abstraction; random-effects meta-analyses qualitative synthesis.

Main Outcomes Measures

Sensitivity, specificity; patient, caregiver, clinician decision-making; function, quality life, neuropsychiatric symptoms; burden well-being.

Results

The included 287 more than 280 000 adults. One randomized clinical trial (RCT) (n = 4005) examined direct effect for on outcomes, including potential harms, finding no significant differences health-related life 12 months (effect size, 0.009 [95% CI, –0.063 0.080]). Fifty-nine 38 531) addressed 49 detect impairment. Mini-Mental State Examination was most-studied instrument, a pooled sensitivity 0.89 (95% 0.85 0.92) specificity 0.93) dementia using cutoff 23 less 24 (15 studies, n 796). Two hundred twenty-four RCTs 3 observational 240 patients caregivers treatment MCI dementia. None trials were linked program; all cases, participants known Medications approved Alzheimer disease (donepezil, galantamine, rivastigmine, memantine) improved scores ADAS-Cog 11 by 1 2.5 points over years. Psychoeducation resulted small benefit (standardized mean difference, –0.24 –0.36 –0.13) months. Intervention uncertain importance.

Conclusions Relevance

Screening can adequately There is empirical evidence, however, that improves outcomes causes harm. It remains unclear whether provide clinically important earlier detected

Language: Английский

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The Efficacy of Cognitive Intervention in Mild Cognitive Impairment (MCI): a Meta-Analysis of Outcomes on Neuropsychological Measures

Neuropsychology Review, Journal Year: 2017, Volume and Issue: 27(4), P. 440 - 484

Published: Dec. 1, 2017

Cognitive training in MCI may stimulate pre-existing neural reserves or recruit circuitry as "compensatory scaffolding" prompting neuroplastic reorganization to meet task demands (Reuter-Lorenz & Park, 2014). However, existing systematic reviews and meta-analytic studies exploring the benefits of cognitive interventions have been mixed. An updated examination regarding efficacy intervention is needed given improvements adherence diagnostic criteria subject selection, better defined strategies applied, increased use neuropsychological measures pre- post-intervention, well identification moderator variables which influence treatment. As such, this review was conducted examine individuals diagnosed with mild impairment (MCI) versus controls based on performance outcome randomized controlled trials (RCT). RCT published from January 1995 June 2017 were obtained through source databases MEDLINE-R, PubMed, Healthstar, Global Health, PSYCH-INFO, Health Psychological Instruments using search parameters for category (mild impairment, MCI, pre-Alzheimer's disease, early decline, onset Alzheimer's preclinical disease) (intervention, training, stimulation, rehabilitation, treatment). Other inclusion exclusion included selection established criteria, design an outpatient setting, (active passive), outcomes objective measures. From 1199 abstracts identified, 26 articles met meta-analyses completed across eleven (11) countries; 92.31% within past 7 years. A series performed effects by domain, type content (cognitive domain targeted). We found significant, moderate multicomponent (Hedges' g observed = 0.398; CI [0.164, 0.631]; Z 3.337; p 0.001; Q 55.511; df 15; 0.000; I 2 72.978%; τ 0.146) multidomain-focused 0.230; 95% [0.108, 0.352]; 3.692; < 12.713; 12; 0.390; 5.612; 0.003). The other explored type, indeterminate due concerns heterogeneity, bias, small cell sizes. In addition, subgroup meta-regression analyses moderators category, mode intervention, content, program duration (total hours), control group post-intervention follow-up assessment period, repeat administration. significant overall memory focused appearing be more effective than multidomain approaches. There no evidence covariates examined. Overall, these findings suggest who received targeting multiple domains (including lifestyle changes) apt display improvement cognition post-intervention. forms prompt recruitment alternate processes support primary networks simultaneously. appear particularly helpful, memory-based approaches possibly being methods. factors, such duration, less outcomes. Given this, although creation new network paths appears strained facilitate partial activation compensatory scaffolding reorganization. positive benefit also reflect transfer indicative multiple-pathways involved processes. Limitations are similar meta-analysis including a modest number studies, sample sizes, types applied (some overlapping), and, while greatly improved our view, large diversity instruments used measure outcome. This contributed presence heterogeneity publication bias precluding definitive determination observed.

Language: Английский

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Combined physical and cognitive training for older adults with and without cognitive impairment: A systematic review and network meta-analysis of randomized controlled trials

Ageing Research Reviews, Journal Year: 2020, Volume and Issue: 66, P. 101232 - 101232

Published: Nov. 26, 2020

Language: Английский

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The neural correlates of physical exercise-induced general cognitive gains: A systematic review and meta-analysis of functional magnetic resonance imaging studies

Neuroscience & Biobehavioral Reviews, Journal Year: 2025, Volume and Issue: 169, P. 106008 - 106008

Published: Jan. 10, 2025

Language: Английский

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The Aerobic and Cognitive Exercise Study (ACES) for Community-Dwelling Older Adults With or At-Risk for Mild Cognitive Impairment (MCI): Neuropsychological, Neurobiological and Neuroimaging Outcomes of a Randomized Clinical Trial

Frontiers in Aging Neuroscience, Journal Year: 2018, Volume and Issue: 10

Published: May 4, 2018

Prior research has found that cognitive benefits of physical exercise and brain health in older adults may be enhanced when mental is interactive simultaneously, as exergaming. It unclear whether the benefit can maximized by increasing degree challenge during exercise. This randomized clinical trial (RCT), Aerobic Cognitive Exercise Study (ACES) sought to replicate extend prior findings added from exergaming those with or at risk for mild impairment (MCI). ACES compares effects six months an exer-tour (virtual reality bike rides) a more effortful exer-score (pedaling through videogame score points). Fourteen community-dwelling meeting screening criteria MCI (sMCI) were adherent their assigned months. The primary outcome was executive function, while secondary outcomes included memory everyday function. Exer-tour yielded significant moderate on function (Stroop A/C; d's = .51 .47); there no interaction effect. However, after three revealed effect, showed little impact, did game-only condition. Both conditions also resulted improvements verbal memory. Effects appear generalize self-reported Pilot data, including salivary biomarkers structural MRI, gathered baseline months; dose associated increased BDNF well grey matter volume PFC ACC. Improvement increase DLPFC. Improved expression exosomal miRNA-9. Interactive (both high low challenge) similarly sMCI exercisers over A larger RCT needed confirm these findings. Further innovation data are develop accessible, yet engaging effective interventions combat decline growing population.

Language: Английский

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The space where aging acts: focus on the GABAergic synapse

Aging Cell, Journal Year: 2017, Volume and Issue: 16(4), P. 634 - 643

Published: May 12, 2017

As it was established that aging is not associated with massive neuronal loss, as believed in the mid-20th Century, scientific interest has addressed influence of on particular subpopulations and their synaptic contacts, which constitute substrate for neural plasticity. Inhibitory neurons represent most complex diverse group neurons, showing distinct molecular physiological characteristics possessing a compelling ability to control physiology circuits. This review focuses GABAergic synapses. Understanding how affects synapses may help explain heterogeneity aging-related effects. We reviewed literature concerning effects numbers well alterations presynaptic postsynaptic components. Finally, we discussed those changes plasticity system, highlighting our results mouse somatosensory cortex linking them impairments brain disorders. posit aging-induced system lead an inhibitory/excitatory imbalance, thereby decreasing neuron's respond plastic environmental cellular challenges, leaving more vulnerable cognitive decline damage by synaptopathic diseases.

Language: Английский

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Aerobic Exercise Training Improves Cerebral Blood Flow and Executive Function: A Randomized, Controlled Cross-Over Trial in Sedentary Older Men

Frontiers in Aging Neuroscience, Journal Year: 2019, Volume and Issue: 11

Published: Dec. 3, 2019

Physical activity may attenuate age-related cognitive decline by improving cerebrovascular function. The aim of this study was therefore to investigate effects aerobic exercise training on cerebral blood flow (CBF), which is a sensitive physiological marker function, in sedentary older men.Seventeen apparently healthy men, aged 60-70 years and with BMI between 25 35 kg/m2, were included randomized, controlled cross-over trial. Study participants randomly allocated fully-supervised, progressive, or no-exercise control period for 8 weeks, separated 12-week wash-out period. Measurements at the end each fitness evaluated using peak oxygen consumption during incremental (VO2peak), CBF measured pseudo-continuous arterial spin labeling magnetic resonance imaging, post-load glucose responses determined an oral tolerance test (OGTT). Furthermore, performance assessed domains executive memory, psychomotor speed.VO2peak significantly increased following compared 262 ± 236 mL (P < 0.001). 27% bilaterally frontal lobe, particularly subcallosal anterior cingulate gyrus (cluster volume: 1008 mm3; P 0.05), while reduced 19% right medial temporal mainly fusiform 408 0.05). Mean concentrations OGTT decreased 0.33 0.63 mmol/L = 0.049). function improved as latency response 5% 0.034), but no changes observed memory speed.Aerobic improves regional men. These underlie exercise-induced beneficial could be partly mediated improvements metabolism. This clinical trial registered ClinicalTrials.gov NCT03272061.

Language: Английский

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Intracerebral Injection of Extracellular Vesicles from Mesenchymal Stem Cells Exerts Reduced Aβ Plaque Burden in Early Stages of a Preclinical Model of Alzheimer’s Disease

Cells, Journal Year: 2019, Volume and Issue: 8(9), P. 1059 - 1059

Published: Sept. 10, 2019

Bone marrow Mesenchymal Stem Cells (BM-MSCs), due to their strong protective and anti-inflammatory abilities, have been widely investigated in the context of several diseases for possible therapeutic role, based on release a highly proactive secretome composed soluble factors Extracellular Vesicles (EVs). BM-MSC-EVs, particular, convey many beneficial features parental cells, including direct indirect β-amyloid degrading-activities, immunoregulatory neurotrophic abilities. Therefore, EVs represent an extremely attractive tool purposes neurodegenerative diseases, Alzheimer’s disease (AD). We examined potential BM-MSC-EVs injected intracerebrally into neocortex APPswe/PS1dE9 AD mice at 3 5 months age, time window which cognitive behavioral phenotype is not yet detectable or has just started appear. demonstrate that are effective reducing Aβ plaque burden amount dystrophic neurites both cortex hippocampus. The presence Neprilysin opens possibility degrading action. Our results indicate role already early stages AD, suggesting intervening before overt clinical manifestations.

Language: Английский

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The Potential of Immersive Virtual Reality for Cognitive Training in Elderly

Gerontology, Journal Year: 2020, Volume and Issue: 66(6), P. 614 - 623

Published: Jan. 1, 2020

The number of elderly is growing rapidly, including those that struggle with cognitive decline and, consequently, activities daily living. Developing interventions slow down would greatly benefit the autonomy these elderly, as well their caretakers. Virtual reality (VR) an immersive and interactive human-computer interface real-time simulation suggested to be a promising tool improve functioning. This literature review discusses features VR, its opportunities limitations, are special relevance for improving cognition in elderly. First, high flexibility VR allows personalized safe training potentially harmful situations isolated aspects tasks. Second, VR’s dynamic feedback on performance provides labor-extensive caretakers care. Third, acquisition resolution data enables exposure subtle changes over time, relevant detecting nature extent dementia. Fourth, has been related cybersickness. Finally, perception expression emotions, motor behaviors, multiple senses. Aged subjects found have sparing emotional learning show increased reliance multisensory integration learning. Moreover, they experience levels flow, motivation, presence setups. Despite clear potential studies available small scale not replicated. digital illiteracy healthcare personnel form additional barrier implementation. Hence, while replication outcomes standardization required before it can used standard care, may provide particularly effective

Language: Английский

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