Healthy brain aging and cognitive function are promoted by exercise. The benefits of exercise are attributed to several mechanisms, many which highlight its neuroprotective role via actions that enhance neurogenesis, neuronal morphology and/or neurotrophin release. However, the brain is also composed of glial and vascular elements, and comparatively less is known regarding the effects of exercise on these components in the aging brain. Here, we show that aerobic exercise at mid-age decreased markers of unhealthy brain aging including astrocyte hypertrophy, a hallmark of brain aging. Middle-aged female mice were assigned to a sedentary group or provided a running wheel for six weeks. Exercise decreased hippocampal astrocyte and myelin markers of aging but increased VEGF, a marker of angiogenesis. Brain vascular casts revealed exercise-induced structural modifications associated with improved endothelial function in the periphery. Our results suggest that age-related astrocyte hypertrophy/reactivity and myelin dysregulation are aggravated by a sedentary lifestyle and accompanying reductions in vascular function. However, these effects appear reversible with exercise initiated at mid-age. As this period of the lifespan coincides with the appearance of multiple markers of brain aging, including initial signs of cognitive decline, it may represent a window of opportunity for intervention as the brain appears to still possess significant vascular plasticity. These results may also have particular implications for aging females who are more susceptible than males to certain risk factors which contribute to vascular aging.

Objective: To assess the effectiveness of therapeutic phototherapy including laser, light-emitting diode, and supraluminous diode energy, in the management of osteoarthritis in aging and older adults. Methods: A systematic review of PubMed and CINAHL was completed using the following search terms and their associated abbreviations: laser, supraluminous diode (SLD), or light-emitting diode (LED) combined with therapy, intervention, or treatment. We included randomized controlled trials published between January 1, 2008, and December 31, 2018, written in English, and included human subjects who had a central tendency for age greater than or equal to 50 years. Results: Twenty-two randomized controlled trials met our search criteria. Multiple pathologies were evaluated including knee osteoarthritis (n = 20), total hip arthroplasty (n = 1), and hand osteoarthritis (n = 1). Of these 22 studies, 2 compared laser to control, 8 compared laser to sham or placebo, 1 compared laser to therapeutic exercise, 1 compared laser with exercise to control, 3 compared laser paired with exercise to exercise only, 4 compared laser with exercise to placebo with exercise, 3 compared laser to other modalities, 3 compared laser with other modalities to other modalities, 1 compared laser with other modalities to exercise with other modalities, 1 compared laser with exercise and glucosamine/chondroitin sulfate (GCS) to GCS and exercise as well as placebo and exercise, 1 compared laser intensities, and 2 compared laser used with ultrasound (US) to placebo as well as combination laser/US with exercise to placebo and only the combination laser/US unit. As demonstrated by this variability, a meta-analysis was not appropriate. Studies on knee osteoarthritis varied slightly in their results, but the majority of groups that received laser showed significant improvements in pain, function, and quality of life when compared with placebo or control. High-intensity laser demonstrated larger improvements when compared with low-level laser therapy. Histological studies found significant changes in some of the markers associated with tissue healing favoring the laser treatment groups. Conclusion: The studies included all used a form of laser in their light therapy treatment protocols. There is some evidence that light therapy may provide statistically significant improvements in pain, function, and quality of life; however, results varied from study to study. Further research is needed to better evaluate the parameters associated with laser when used to treat conditions associated with osteoarthritis that affect aging and older adults.

Objective: To assess the effectiveness of therapeutic electromagnetic energy in the management of conditions associated with an aging and older adult population. Methods: A systematic review of literature from 2008 to 2018 was completed in PubMed, CINAHL, and Science Direct. We also reviewed sources to identify additional relevant studies. Studies in this review were limited to randomized controlled trials that evaluated the effects of shortwave diathermy or pulsed electromagnetic energy units in treating conditions commonly experienced by adults older than 50 years. Study quality was determined using the Physiotherapy Evidence Database (PEDro) classification scale. Results: Fifteen randomized controlled trials met our search criteria. Multiple pathologies were evaluated with the studies examining treatment effects of knee osteoarthritis (n = 12), frozen shoulder (n = 1), postoperative rotator cuff repair (n = 1), and postmenopausal osteoporosis (n = 1). Of the 12 studies that examined knee osteoarthritis, 2 compared pulsed electromagnetic field to placebo or sham, 2 compared the addition of shortwave diathermy to strengthening activities alone, 3 evaluated shortwave diathermy dosage, 3 compared shortwave diathermy to other modalities, and 2 reviewed the benefits of adding pulsed electromagnetic field to other modalities and exercise. Due to the high degree of variability in protocols and outcome measures among studies, meta-analysis was not appropriate. Studies on knee osteoarthritis reported that the use of pulsed electromagnetic field and shortwave diathermy provides statistically significant improvement in pain and function compared with placebo, sham, or control, although there appears to be no benefit in using either form of electromagnetic radiation in addition to or in place of another modality. It also appears that dosage does not significantly change short-term outcomes. These findings are similar to those identified in other recently published systematic reviews that focused exclusively on knee osteoarthritis. Subjects with shoulder pathologies showed improvements in pain, mobility (range of motion), function, activities of daily living, and pain medication usage with pulsed electromagnetic field or shortwave diathermy. Changes in postmenopausal bone density were similar when pulsed electromagnetic field was compared with medication. Conclusion: Shortwave diathermy and pulsed electromagnetic frequency demonstrate similar clinical benefits as other modalities for improving pain, function, and quality of life in the short-term. Further research is needed to better evaluate the parameters of electromagnetic energy and effects for other conditions commonly affecting aging and older adults and at other treatment sites on the body.