Effect of Physical Exercise on Cognitive Performance in Older Adults with Mild Cognitive Impairment or Dementia: A Systematic Review

Öhman, Hanna; Savikko, Niina; Strandberg, Timo; Pitkälä, Kaisu H.

doi:10.1159/000365388

Cited by 233 publications

(207 citation statements)

References 46 publications

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“…Almost all randomized studies in patients with mild cognitive impairment (MCI) demonstrate some positive effects on one or several domains of cognition [7]. In one of the largest randomized trials of aerobic exercise in MCI subjects, tests of executive function (Symbol Digit Modalities, Verbal Fluency, and Stroop) showed improvement, whereas memory tests did not, suggesting that certain cognitive domains are more amendable to exercise than others [8].…”

Section: Introductionmentioning

confidence: 99%

“…In one of the largest randomized trials of aerobic exercise in MCI subjects, tests of executive function (Symbol Digit Modalities, Verbal Fluency, and Stroop) showed improvement, whereas memory tests did not, suggesting that certain cognitive domains are more amendable to exercise than others [8]. In studies of dementia and AD, one recent review [7] and an updated meta-analysis [9] underscore the need for caution in interpreting findings due to methodological issues. Further, some studies in patients with AD or MCI have relied on unsupervised, caregiver supervised, or partly unsupervised exercise [8,10,11].…”

Section: Introductionmentioning

confidence: 99%

“…Further, some studies in patients with AD or MCI have relied on unsupervised, caregiver supervised, or partly unsupervised exercise [8,10,11]. Problems with small samples sizes, inadequate randomization procedures, and a lack of sufficient measures of exercise intensity also underscore the need for more rigorously conducted research in this area [7].…”

Section: Introductionmentioning

confidence: 99%

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Moderate-to-High Intensity Physical Exercise in Patients with Alzheimer’s Disease: A Randomized Controlled Trial

Hoffmann

Sobol

Frederiksen

et al. 2016

JAD

246

260

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Abstract.Background: Studies of physical exercise in patients with Alzheimer's disease (AD) are few and results have been inconsistent. Objective: To assess the effects of a moderate-to-high intensity aerobic exercise program in patients with mild AD. Methods: In a randomized controlled trial, we recruited 200 patients with mild AD to a supervised exercise group (60-min sessions three times a week for 16 weeks) or to a control group. Primary outcome was changed from baseline in cognitive performance estimated by Symbol Digit Modalities Test (SDMT) in the intention-to-treat (ITT) group. Secondary outcomes included changes in quality of life, ability to perform activities of daily living, and in neuropsychiatric and depressive symptoms. Results: The ITT analysis showed no significant differences between intervention and control groups in change from baseline of SDMT, other cognitive tests, quality of life, or activities of daily living. The change from baseline in Neuropsychiatric Inventory differed significantly in favor of the intervention group (mean: -3.5, 95% confidence interval (CI) -5.8 to -1.3, p = 0.002). In subjects who adhered to the protocol, we found a significant effect on change from baseline in SDMT as compared with the control group (mean: 4.2, 95% CI 0.5 to 7.9, p = 0.028), suggesting a dose-response relationship between exercise and cognition. * Correspondence to: Professor, DMSc, MD, Steen G. K. Hoffmann et al. / Aerobic exercise in Alzheimer's diseaseConclusions: This is the first randomized controlled trial with supervised moderate-to-high intensity exercise in patients with mild AD. Exercise reduced neuropsychiatric symptoms in patients with mild AD, with possible additional benefits of preserved cognition in a subgroup of patients exercising with high attendance and intensity.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Moderate-to-High Intensity Physical Exercise in Patients with Alzheimer’s Disease: A Randomized Controlled Trial

Hoffmann

Sobol

Frederiksen

et al. 2016

JAD

246

260

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“…The weight was subsequently increased if the participant was able to perform two additional repetitions with good form, or decreased if the participant could not perform the required number of repetitions. A systematic review concluded that long intervention duration, high exercise intensity and good adherence all appear to be important in obtaining cognitive benefits in people with dementia or mild cognitive impairment [35].…”

Section: Exercise Interventionsmentioning

confidence: 99%

Motoric functions and cognition in elderly

Jovanović¹,

Pavlović²

2016

Engrami

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SummaryThe prolonging of a lifespan and the increasing proportion of elderly people in general population are setting new healthcare tasks. One of them is researching and clarifying the relations and links between motoric and cognitive functions in elderly. "Impoverishment" of cognitive capacities occurs during the aging process. Many studies show a strong link between cognition and the function of walking. There is growing evidence that the decline in cognitive functions is resulting in deterioration of walking. Usually described as characteristic of the later stages of dementia, the distortion of ambulation may also be present in the earlier stages, even before the prodromal stage of mild cognitive impairment. Speed and temporal and spatial variability of steps are the main gait characteristics which are connected to the degree of decline in cognitive processes. Those characteristics are motor phenotype that reflects the deterioration of cognitive performance and which can be used for prediction of dementia.It is assumed that physical activity provides beneficial effects at cognitive and psychological levels, including prevention and improvement of depressive states and anxiety disorders, enhancing stress reduction, improved self-confidence and above all it delayes cognitive decline in the elderly. Disruption of axons and myelin in the cerebral white matter is considered one of the primary mechanisms underlying age-related cognitive decline. Therefore, maintaining white matter structural connectivity in the old age may be one of the key factors in preserving brain function and high cognitive performance necessary for independent living. Physical activity also influences cerebrovascular mechanisms, such as preserving higher blood vessel elasticity and wall integrity.Moreover, there is an association between light physical activity and white matter integrity especially in the temporal lobe. The conclusion of some studies shows a relationship between the ε4 allele and brain derived neurotrophic factor (BDNF) response to physiologic adaptation which likely impacts the extent of neuroprotective benefit gained from engagement in physical exercise. Some authors propose a program of exercises which consist of a combined aerobic and resistance training. Motoric function and cognition are closely related and using regular physical activity is important for maintaining physical and mental health in the elderly.

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“…Of note, participants maintained executive and global cognitive benefits for over 18 months (Fiatarone Singh et al 2014). Conversely, other reports have indicated that exercise may not improve cognitive function in healthy older adults and people with MCI (Gates et al 2013;Ohman et al 2014;Young et al 2015). A Cochrane Review found that aerobic exercise did not improve cognitive function in older adults without known cognitive impairment (Young et al 2015).…”

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confidence: 98%

The role of exercise in mitigating subcortical ischemic vascular cognitive impairment

Dao

Hsiung

Liu-Ambrose

2017

Journal of Neurochemistry

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Subcortical ischemic vascular cognitive impairment (SIVCI) is the most preventable form of cognitive dysfunction. There is converging evidence from animal and human studies that indicate vascular injury as the primary cause of SIVCI. Currently, there are no curative pharmaceutical treatments for vascular dementia; however, exercise may be a promising strategy to combat SIVCI. This review will focus on the role of exercise as a strategy to prevent or slow the progression of SIVCI, with particular emphasis on the mechanisms by which exercise may improve cerebrovascular function. We propose that exercise may be an effective strategy to combat SIVCI by improving cognitive function, increasing the bioavailability of neurotrophins, stimulating endothelial function, and controlling vascular risk factors. Keywords: endothelial function, exercise, subcortical ischemic vascular cognitive impairment, white matter hyperintensities. J. Neurochem. (2018) 144, 582--594.This article is part of the Special Issue "Vascular Dementia".The World Health Organization estimates that 47.5 million people worldwide are living with dementia with an expected increase of 7.7 million new cases each year (World Health Organization 2012). Dementia is a common cause of disability and dependency among older adults; thus, the high prevalence and incidence of dementia is a great burden to health, social, and financial systems (World Health Organization 2012). Vascular cognitive impairment (VCI) is the second leading cause of cognitive impairment and dementia (van Norden et al. 2012). Vascular cognitive impairment is an umbrella term that encompasses the full spectrum of cognitive and functional impairments associated with cerebrovascular disease, from frank dementia to mild cognitive deficits (Gorelick et al. 2011). Subcortical ischemic vascular cognitive impairment (SIVCI) is the most common form of VCI and is caused by cerebral small vessel disease (SVD) (Moorhouse and Rockwood 2008). Cerebral SVD is caused by chronic and diffuse ischemia and is most often associated with damage to cerebral white matter. Specifically, it manifests as white matter hyperintensities (WMH), lacunes, enlarged perivascular spaces, and microbleeds (Wardlaw et al. 2013b).Overall, there is converging evidence from animal and human studies that indicate vascular injury as the primary cause of SIVCI (Iadecola 2013). Vascular risk factors such as Received May 29, 2017; revised manuscript received August 9, 2017; accepted August 11, 2017.Address correspondence and reprint requests to Teresa Liu-Ambrose, University of British Columbia, Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3. USA. E-mail: teresa.ambrose@ubc.caAbbreviations used: ADAS-Cog, Alzheimer's Disease Assessment Scale-cognitive subscale; BDNF, brain-derived neurotrophic factor; CBF, cerebral blood flow; eNOS, endothelial nitric oxide synthase; fMRI, functional magnetic resonance imaging MRI; IGF-1, insulin-like growth factor 1; MCI, mild cognitive impairment; MRI, m...

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Effect of Physical Exercise on Cognitive Performance in Older Adults with Mild Cognitive Impairment or Dementia: A Systematic Review

Cited by 233 publications

References 46 publications

Moderate-to-High Intensity Physical Exercise in Patients with Alzheimer’s Disease: A Randomized Controlled Trial

Moderate-to-High Intensity Physical Exercise in Patients with Alzheimer’s Disease: A Randomized Controlled Trial

Motoric functions and cognition in elderly

The role of exercise in mitigating subcortical ischemic vascular cognitive impairment

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