A growing number of studies have shown that mind-body exercise is beneficial to cognitive function, especially memory, in elderly MCI patients. However, few studies have explored the effect of mind-body exercise on the attention of MCI population. We recruited 69 participants and divided them equally into Baduanjin, brisk walking (BWK) exercise or usual physical activity (UAP) control groups. The two exercise groups performed 60 min of exercise three times per week for 24 weeks. All subjects underwent whole-brain functional MRI and assessment of attentional abilities, including selective, divided, and sustained attention, and processing speed at baseline and after 24 weeks. The results show that: Baduanjin exercise significantly increased the selective attention of MCI patients, and Dorsal attention network (DAN) of Baduanjin exercise group exhibited functional connectivity decreased in right rolandic operculum (ROL. R), right middle temporal gyrus (MTG. R), right supramarginal inferior parietal, angular gyri (IPL. R), right precuneus (PCUN. R), and right fusiform gyrus (FFG. R) regions compared with the other two groups. The BWK exercise group had obviously functional connectivity increased in IPL. R and decreased in the MTG. R region compared to that in the UAP group. But no significant association between the changes of functional connectivity of DAN and the change of attentional ability test was observed. Thus, our data indicated Baduanjin exercise may be a potential beneficial intervention to improve the attention of the elderly with MCI. Further study with more samples is necessary to elucidate its imaging mechanism.

IntroductionCognitive frailty (CF) is a clinical manifestation characterised by the simultaneous presence of both physical frailty and cognitive impairment among older adults without dementia and has become a new target for healthy ageing. Increasing evidence shows that regular Baduanjin (a traditional Chinese mind–body exercise) training is beneficial in improving physical function and cognitive ability in the older adults. The primary aim of this trial is to observe the effect of Baduanjin on physical and cognitive functions in older adults with CF.Methods and analysisIn this prospective, outcome assessor-blind, two-arm randomised controlled trial, a total of 102 participants with CF will be recruited and randomly allocated (1:1) into the Baduanjin training or usual physical activity control group. The control group will receive health education for 30 min at least once a month. Based on health education, participants in the Baduanjin exercise group will receive a 24-week Baduanjin training with 60 min per session and 3 sessions per week, while those in the usual physical activity control group will maintain their original lifestyle. Primary outcomes (frailty index and global cognitive ability), body composition, grip force, balance, fatigue, specific cognitive domain, including memory, execution and visual spatial abilities, and life quality of secondary outcomes will be measured at baseline, and at 13 and 25 weeks after randomisation, while the structural and functional MRI will be measured at baseline and 25 weeks after randomisation. The mixed linear model will be conducted to observe the intervention effects.Ethics and disseminationThe study has been approved by the ethics committee of the second people’s hospital of Fujian province (Approval no. 2018-KL015). Results will be submitted for publication in peer-reviewed journals and disseminated at scientific conferences.Trial registration numberChiCTR1800020341; Pre-results.

No abstract

No abstract

Background: Oxidative stress (OS) plays an important role in the progression of many aging-related diseases. Exercises can delay this kind of progress, but aerobic exercise is the most commonly used type of training among older adults; therefore, its influence needs to be further verified.Methods: A literature search was conducted in eight electronic databases, including Cochrane, EMBASE, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Date, and SinoMed from their inception to April 2020. Methodological quality was assessed using Cochrane RoB tool v2.0 for individual studies, and RevMan 5.3 software was used to perform the meta-analysis.Results: The meta-analysis included 20 studies, involving 1,170 older adults. The results showed that regular aerobic exercise could reduce blood oxidant markers, including malondialdehyde (MDA; SMD=−1.80, 95% CI −2.46 to −1.14, p<0.001) and lipid peroxide (LPO; SMD=−1.12, 95% CI −2.03 to −0.22, p=0.02), and increase the levels of antioxidant factors, such as nitric oxide (NO; SMD=0.89, 95% CI 0.37–1.41, p<0.001), superoxide dismutase (SOD; SMD=0.63, 95% CI 0.25–1.01, p=0.001), and total antioxidant capacity (TAC; SMD=1.22, 95% CI 0.45–1.98, p=0.002), with clear statistical significance. It may also improve the levels of other OS markers, such as 8-OHdG, 8-isoPGF2, VE, and reduced glutathione/oxidized glutathione (GSH/GSSG).Conclusion: Regular aerobic exercise may have a positive effect on the OS levels of older adults by reducing some oxidant markers and increasing antioxidant marker levels.

Background: Cognitive frailty (CF) is defined as the simultaneous presence of physical frailty and cognitive impairment among older adults without dementia. Previous studies have revealed that neuropathological changes may contribute to the degeneration of subcortical nuclei in the process of cognitive impairment. However, it is unclear in CF. The aim of this study is to investigate the changes in subcortical nuclei in older adults with CF and their relationship with cognitive decline and physical frailty. Methods: A total of 26 older adults with CF and 26 matched healthy subjects were enrolled. Cognitive function and physical frailty were assessed with the Montreal Cognitive Assessment (MoCA) scale (Fuzhou version) and the Chinese version of the Edmonton Frailty Scale (EFS). Volumetric and diffusion tensor imaging (DTI) parameters of subcortical nuclei were measured with structural and DTI brain magnetic resonance imaging (MRI) and compared between groups. Partial correlation analysis was conducted between subcortical nuclei volumes, MoCA scores, and physical frailty indexes. Results: Significant volume reductions were found in five subcortical nuclei, including the bilateral thalami, left caudate, right pallidum, and accumbens area, in older adults with CF (P < 0.05), and the bilateral thalami was most obvious. Decreased fractional anisotropy and relative anisotropy values were observed only in the left thalamus in the CF group (P < 0.05). No group differences were found in apparent diffusion coefficient (ADC) values. The MoCA scores were positively correlated with the volumes of the bilateral thalami, right pallidum, and accumbens area (P < 0.05). Negative correlations were found between the physical frailty index and the volumes of the bilateral thalami, caudate, pallidum, and right accumbens area (P < 0.05). Conclusion: Microstructural changes occur in the subcortical nuclei of older adults with CF, and these changes are correlated with cognitive decline and physical frailty. Therefore, microstructural atrophy of the subcortical nuclei may be involved in the pathological progression of CF.

BackgroundCognitive frailty is a particular state of cognitive vulnerability toward dementia with neuropathological hallmarks. The hippocampus is a complex, heterogeneous structure closely relates to the cognitive impairment in elderly which is composed of 12 subregions. Atrophy of these subregions has been implicated in a variety of neurodegenerative diseases. The aim of this study was to explore the changes in hippocampal subregions in older adults with cognitive frailty and the relationship between subregions and cognitive impairment as well as physical frailty.MethodsTwenty-six older adults with cognitive frailty and 26 matched healthy controls were included in this study. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA) scale (Fuzhou version) and Wechsler Memory Scale-Revised Chinese version (WMS-RC), while physical frailty was tested with the Chinese version of the Edmonton Frailty Scale (EFS) and grip strength. The volume of the hippocampal subregions was measured with structural brain magnetic resonance imaging. Partial correlation analysis was carried out between the volumes of hippocampal subregions and MoCA scores, Wechsler’s Memory Quotient and physical frailty indexes.ResultsA significant volume decrease was found in six hippocampal subregions, including the bilateral presubiculum, the left parasubiculum, molecular layer of the hippocampus proper (molecular layer of the HP), and hippocampal amygdala transition area (HATA), and the right cornu ammonis subfield 1 (CA1) area, in older adults with cognitive frailty, while the proportion of brain parenchyma and total number of white matter fibers were lower than those in the healthy controls. Positive correlations were found between Wechsler’s Memory Quotient and the size of the left molecular layer of the HP and HATA and the right presubiculum. The sizes of the left presubiculum, molecular of the layer HP, and HATA and right CA1 and presubiculum were found to be positively correlated with MoCA score. The sizes of the left parasubiculum, molecular layer of the HP and HATA were found to be negatively correlated with the physical frailty index.ConclusionSignificant volume decrease occurs in hippocampal subregions of older adults with cognitive frailty, and these changes are correlated with cognitive impairment and physical frailty. Therefore, the atrophy of hippocampal subregions could participate in the pathological progression of cognitive frailty.

Background and purpose Chinese mind–body exercise-Baduanjin has received increasing attention for health promotion among middle-aged and older adults in China, but there is a lack of high-quality evidence on its effectiveness. This systematic review and meta-analysis was conducted to investigate the effects of Baduanjin on physical function in middle-aged and older adults. Methods Seven electronic databases were searched for articles published before 22 June 2021 with the keywords Baduanjin exercise combined with physical-function-related outcomes. Risk of bias was assessed in the included studies, and data were analyzed using Review Manager software V5.3. Results Fifteen articles, including 14 randomized controlled trials, were included in this study. The results of the meta-analysis showed that Baduanjin significantly improved muscle strength (grip strength: SMD = 0.63, 95% CI 0.22 to 1.04, p = 0.003), balance ability (timed up-and-go test score: MD = -2.21, 95% CI -3.91 to -0.51, p = 0.01; one-leg stand test score: MD = 3.75, 95% CI 1.96 to 5.55, p < 0.0001; Berg balance scale score: MD = 4.16, 95% CI 2.49 to 5.83, p < 0.00001; strengthening Romberg’s test result: SMD = 1.02, 95% CI 0.17 to 1.86, p = 0.02); and cardiorespiratory fitness (diastolic blood pressure: MD = -3.62, 95% CI -3.95 to -3.30, p < 0.00001; resting heart rate: MD = -1.30, 95% CI -1.57 to -1.03, p < 0.00001; step test: MD = 4.25, 95% CI 0.76 to 7.74, p = 0.02). No adverse events were reported. Conclusions Baduanjin exercise may be an effective intervention to improve physical function in the middle-aged and elderly population. However, more RCTs with larger sample sizes and more rigorous research designs are needed in the future to confirm the results.