Changes in cardiovascular-health blood biomarkers in response to exercise intervention among older adults with cognitive frailty: A scoping review

Abstract

Introduction: Cardiovascular health contributes significantly to the incidence of cognitive impairment. Prior to conducting exercise-related intervention, it is crucial to explore cardiovascular health blood parameters that have been commonly used as guidance for the purpose of monitoring. Information on the effectiveness of exercise on cardiovascular-related biomarkers is lacking, especially among older adults with cognitive frailty. Therefore, we aimed to review existing evidence on cardiovascular-related blood parameters and their changes following exercise intervention among older adults with cognitive frailty.Methods: A systematic search was conducted on PubMed, Cochrane, and Scopus databases. Related studies involving only human and full text in either English or Malay language were selected. Types of impairment were limited to cognitive impairment, frailty, and cognitive frailty. Studies were restricted to randomized controlled trial and clinical trial design studies. For charting purposes, all variables were extracted and tabulated. Trends in types of parameters studied were explored.Results: A total of 607 articles were screened, and the final 16 were included in this review. Four cardiovascular-related blood parameter categories were extracted: inflammatory, glucose homeostasis, lipid profile, and hemostatic biomarkers. The common parameters monitored were IGF-1 and HbA1c, glucose, and insulin sensitivity in some studies. Out of the nine studies on inflammatory biomarkers, exercise interventions showed a reduction in pro-inflammatory markers, namely, IL-6, TNF-α, IL-15, leptin, and C-reactive protein and an increase in anti-inflammatory markers, namely, IFN-γ and IL-10. Similarly, in all eight studies, glucose homeostasis-related biomarkers had improved with exercise intervention. The lipid profile was tested in five studies, with four studies showing improvements with exercise intervention via a decrease in total cholesterol, triglycerides, and low-density lipoprotein and an increase in high-density lipoprotein. A decrease in pro-inflammatory biomarkers and an increase in anti-inflammatory biomarkers were demonstrated with multicomponent exercise, including aerobic exercise in six studies and aerobic exercise on its own in the remaining two studies. Meanwhile, four out of six studies that yielded improvements in glucose homeostasis biomarkers involved only aerobic exercise and the remaining two studies involved multicomponent with aerobic exercise.Conclusion: The most consistent blood parameters studied were glucose homeostasis and inflammatory biomarkers. These parameters have been shown to improve with multicomponent exercise programs, particularly with the inclusion of aerobic exercise.

Management of cognitive frailty: A network meta‐analysis of randomized controlled trials

“…The effectiveness of multicomponent exercises remains significant within 1 year after ending the intervention, in which the frequency and time for these multicomponent exercises were 45 min three times per week. A scoping review also found multicomponent exercise, especially aerobic, led to the most consistent improvements in blood biomarkers related to CF, such as glucose homeostasis and inflammatory biomarkers 18 . Multicomponent exercises can also increase food intake, improving nutritional status 57 .…”

“…A scoping review also found multicomponent exercise, especially aerobic, led to the most consistent improvements in blood biomarkers related to CF, such as glucose homeostasis and inflammatory biomarkers. 18 Multicomponent exercises can also increase food intake, improving nutritional status. 57 Cognitive function includes memory, attention, language, visual-spatial skills, and executive function.…”

“…However, research on CF has mostly been observational, focusing on the prevalence and risk factors, with insufficient interventional studies. Though physical activity is considered a key component in CF management by most studies 17 , 18 , 19 there is no consensus on whether exercise can improve frailty status in older adults. While some studies have shown exercise do not ameliorate frailty, 20 others have demonstrated such benefits.…”

Detraining and Retraining Effects from a Multicomponent Training Program on the Functional Capacity and Health Profile of Physically Active Prehypertensive Older Women

“…In this context, several studies have already shown the benefits of an MTP on hemodynamic parameters [15,16] and functional capacity [17], as well as improvements in the lipid profile of older women [18,19]. Therefore, this type of training is recommended as a strategy to improve cardiovascular health [20] and physical functioning [21,22], and is advised for older adults in the long term [23,24]. Nonetheless, these individuals are often exposed to physical and behavioral factors [25], including seasonality [26], that result in greater risks of discontinuing an exercise habit.…”

Follow-Up of Eight-Weeks Detraining Period after Exercise Program on Health Profiles of Older Women

“…There is some controversy regarding high serum lipids as a risk factor for mortality among older people, and some studies have shown that increased serum lipids and lipoproteins have been associated with increased risks of all-cause or cardiovascular mortality in older people [10][11][12]; however, other studies have not shown this association [13,14]. Nonetheless, there is no doubt that physical exercise may improve the quality of life [15], cardiovascular [16], musculoskeletal [17], and cognitive health [18], minimizing cardiovascular risk and mortality in older people [19].…”