Effects of Exercise on Cognitive Function in Older People with Dementia: A Randomized Controlled Trial

Toots, Annika; Littbrand, Håkan; Boström, Gustaf; Hörnsten, Carl; Holmberg, Henrik; Lundin-Olsson, Lillemor; Lindelöf, Nina; Nordström, Peter; Gustafson, Yngve; Rosendahl, Erik

doi:10.3233/jad-170014

Cited by 80 publications

(103 citation statements)

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“…We assessed the effects of a 6-month combined aerobic and strength training program with a low (LI, week 1-12) and high (HI, week [13][14][15][16][17][18][19][20][21][22][23][24] intensity phase compared to a control program of matched attention in a randomized controlled study design. We performed blinded assessments of cognitive and physical functions at T0, T12 (after 12 weeks), and T24 (after 24 weeks).…”

Section: Designmentioning

confidence: 99%

“…We found no effects of exercise vs. control activities on cognitive function and no differences between LI (d = − 0.03) and HI (d = − 0.04) exercises. Earlier evidence for the effects of exercise on cognition is conflicted for PwD in nursing homes [10,11,13,71,77] as well as community settings [14,[78][79][80][81]. Studies specifically in daycare or residential care settings are scarce.…”

Section: Effects Of Exercise On Cognitive Functionmentioning

confidence: 99%

“…In healthy older adults, both aerobic and strength exercises are associated with improvements in cognitive functions such as executive function, inhibitory control and episodic memory [3][4][5], and physical functions, i.e., muscle strength, balance, functional reach, mobility, and endurance [4,[6][7][8][9]. Regrettably, the effects of exercise on these cognitive and physical functions in PwD have been inconsistent [5,[10][11][12][13][14]. In PwD, combined aerobic and strength exercise appears to be more effective for cognitive and physical benefits than aerobic training only [11].…”

Section: Introductionmentioning

confidence: 99%

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Effects of low- and high-intensity physical exercise on physical and cognitive function in older persons with dementia: a randomized controlled trial

et al. 2020

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Background: Potential moderators such as exercise intensity or apolipoprotein-E4 (ApoE4) carriership may determine the magnitude of exercise effects on physical and cognitive functions in patients with dementia (PwD). We determined the effects of a 24-week aerobic and strength training program with a low-and high-intensity phase on physical and cognitive function. Methods: In an assessor-blinded randomized trial, 91 PwD (all-cause dementia, recruited from daycare and residential care facilities, age 82.3 ± 7.0 years, 59 women, Mini-Mental State Examination 20.2 ± 4.4) were allocated to the exercise or control group. In the exercise group, PwD participated in a walking and lower limb strength training program with 12 weeks low-and 12 weeks high-intensity training offered three times/week. Attention-matched control participants performed flexibility exercises and recreational activities. We assessed adherence, compliance, and exercise intensity for each session. We assessed physical (endurance, gait speed, mobility, balance, leg strength) and cognitive (verbal memory, visual memory, executive function, inhibitory control, psychomotor speed) functions with performance-based tests at baseline and after 6, 12, 18, 24, and 36 weeks (follow-up). ApoE4 carriership was determined post-intervention.Results: Sixty-nine PwD were analyzed. Their mean attendance was~60% during the study period. There were no significant effects of the exercise vs. control intervention on endurance, mobility, balance, and leg strength in favor of the exercise group (Cohen's d = 0.13-0.18). Gait speed significantly improved with~0.05 m/s after the high-intensity phase for exercise participants (Cohen's d = 0.41) but declined at follow-up. There were no significant effects of the exercise vs. control intervention on any of the cognitive measures (Cohen's d~− 0.04). ApoE4 carriership did not significantly moderate exercise effects on physical or cognitive function.(Continued on next page) Conclusions: Exercise was superior to control activities for gait speed in our sample of PwD. However, the training effect provided no protection for mobility loss after detraining (follow-up). There were no beneficial effects of the exercise vs. control group on cognitive function. Exercise intensity moderated the effects of exercise on gait speed. ApoE4 carriership moderated the effect of exercise on global cognition only (trend level).

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Section: Designmentioning

confidence: 99%

Section: Effects Of Exercise On Cognitive Functionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of low- and high-intensity physical exercise on physical and cognitive function in older persons with dementia: a randomized controlled trial

et al. 2020

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“…While more than one-third of the interventions were beneficial, 14 out of 26 controls significantly decreased. Descriptions of intervention and control groups included in the review are presented in Table 3 [29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54]. All of the included studies were considered to have had a good methodological quality, scoring between 7 and 9 points according to the PEDro.…”

Section: Description Of Studiesmentioning

confidence: 99%

Effects of physical exercise on cognitively impaired older adults: a meta-analysis of randomized control trials

Sontáková

Bártová

Daďová

et al. 2020

Preprint

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Objectives: The main aim of this meta-analysis was to compare the effects of different physical activities on cognitive functions in older adults divided according to cognitive impairment levels. Methods: We searched Web of Science, Scopus, and PubMed for randomized control trials (RCT). A standardized mean difference (SMD) of the pre-post intervention score of global cognitive function tests were calculated by the random model in the Cochrane meta-analyses for people with cognitive impairment generally and across three levels - mild, mild to moderate, and moderate to severe cognitive impairment separately. Additionally, an unstandardized coefficient beta (B) was calculated in generalized linear models to estimate the effects of exercise, cognitive impairment severity, age, female ratio, length of intervention, and time of exercise a week on the global cognitive function. Results: Data from 26 studies involving 1,137 participants from intervention groups and 1,187 participants from control groups were analyzed. Physical exercise had a positive effect on cognitive functions in people across all levels of cognitive impairments SMD (95 % confidence interval [CI]) = 1.19 (0.77 - 1.62); however, heterogeneity was considerably high I 2 = 95%. Aerobic (B = 8.881) and resistance exercise (B = 4.464) was significantly associated with better results in global cognitive functions when compared to active control. A higher number of female participants cin intervention groups had a statistically significant effect on the global cognitive function (B = 0.229). onclusions: Physical exercise was associated with cognitive function improvement in older people with cognitive impairments. Aerobic exercise was more strongly associated than resistance exercise to combat cognitive decline. Keywords: Physical activity, Dementia, Aging, Meta-analysis, Aerobic exercise, Cognitive function

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“…Such supervised simple exercises might include passing a ball to a seatmate, rising from the chair, stepping, or walking a little further. It seems to be still too limited and vastly inefficient, even in the case of high-intensity functional exercise programs [38]. The executive demands are very often insufficient.…”

Section: Does a Movement Really Work To Maintain Your Brain?mentioning

confidence: 99%

Shedding Light on a New Psychology of Movement and Exercise

Deschamps¹

2019

obm icm

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Let's consider the issues of exercise and cognitive function from a different angle, for instance, by moving from a sitting position to standing. Seeing something from different perspectives not only reflects our cognitive flexibility [1] but also has a direct impact on executive performance. Interestingly, some recent studies have reported a smaller Stroop effect when standing than sitting [2-3] or stepping backward [4]. This evidences that body posture enhances selective attention and cognitive control. Through these examples, the assumption presented here is that our daily cognitive functioning is closely linked to our sensorimotor present and vice-versa. Our abilities to move are cognitively vital. Hence a call for a new psychology of movement and, by extension, of exercise emerges [2], with consequences for how to address the role and the effects of movement and exercise on cognitive function.

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Effects of Exercise on Cognitive Function in Older People with Dementia: A Randomized Controlled Trial

Cited by 80 publications

References 50 publications

Effects of low- and high-intensity physical exercise on physical and cognitive function in older persons with dementia: a randomized controlled trial

Effects of low- and high-intensity physical exercise on physical and cognitive function in older persons with dementia: a randomized controlled trial

Effects of physical exercise on cognitively impaired older adults: a meta-analysis of randomized control trials

Shedding Light on a New Psychology of Movement and Exercise

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