Physical activity to improve cognition in older adults: can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis

Gheysen, Freja; Poppe, Louise; DeSmet, Ann; Swinnen, Stephan P.; Cardon, Greet; Bourdeaudhuij, Ilse De; Chastin, Sébastien; Fias, Wim

doi:10.1186/s12966-018-0697-x

Cited by 222 publications

(229 citation statements)

References 75 publications

(104 reference statements)

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“…Previous meta‐analyses mostly focused on one type of mind‐body exercise, such as tai chi, yoga, or dance, for cognitive functions . Other reviews explored physical exercise including aerobic, resistance exercise, tai chi, or yoga for preventing and addressing cognitive impairment in older adults . Although these reviews involved mind‐body exercise as a component, the studies mainly focused on aerobic and resistance exercise, which might increase the confounding factors and cannot comprehensively and accurately assess the effect of mind‐body exercises on cognitive functions.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10]51 Other reviews explored physical exercise including aerobic, resistance exercise, tai chi, or yoga for preventing and addressing cognitive impairment in older adults. [52][53][54] Although these reviews involved mind-body exercise as a component, the studies mainly focused on aerobic and resistance exercise, which might increase the confounding factors and cannot comprehensively and accurately assess the effect of mind-body exercises on cognitive functions. Therefore, our study paid more attention to the overall effects of mind-body exercise and comprehensively evaluated cognitive performance on cognitive intact and cognitive impairment in older adults, which was different from what was found in previous studies.…”

Section: Findings In Relation To Previous Reviewsmentioning

confidence: 99%

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Effects of Mind‐Body Exercises on Cognitive Function in Older Adults: A Meta‐Analysis

Zheng

et al. 2018

J American Geriatrics Society

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BACKGROUND/OBJECTIVES Mind‐body exercise has positive effects on cognitive performance, according to clinical observation and experts’ recommendations. However, its potential benefits for the cognitive function of aging adults are uncertain and still lack systematic estimations. Therefore, we conducted a systematic review and meta‐analysis to evaluate the overall efficacy and effectiveness of mind‐body exercises for cognitive performance in aging individuals with or without cognitive impairment. DESIGN A systematic review and meta‐analysis. SETTING AND PARTICIPANTS We searched related trials through June 2018 from four databases: Medline, Embase, PsycINFO (all via Ovid), and the Cochrane Library/Central Register of Controlled Trials. MEASUREMENTS Methodological quality was assessed using the Cochrane Risk of Bias Tool. A meta‐analysis of comparative effects was performed using Review Manager v.5.3 software, and publication bias was examined using Egger's test. RESULTS A total of 32 randomized controlled trials with 3624 participants were ultimately included in this meta‐analysis. The results revealed that mind‐body exercises as a whole had benefits in improving global cognition compared with that of the control group (mean difference [MD] = 0.92; 95% confidence interval [CI] = 0.33‐1.51; p = .002) and were more effective than control interventions in promoting cognitive flexibility (MD = −8.80; 95% CI = −15.22 to −2.38; p = .007), working memory (MD = 0.32; 95% CI = 0.01‐0.64; p = .05), verbal fluency (standardized mean difference [SMD] = 0.27; 95% CI = 0.09‐0.45; p = .003), and learning (SMD = 0.24; 95% CI = 0.10‐0.39; p = .001) on cognitively intact or impaired older adults. In dose‐subgroup analysis, only moderate exercise intensity (60‐120 min per week) significantly increased global cognition scores compared with those of the control group (MD = 1.15; 95% CI = 0.34‐1.97; p = .006). CONCLUSION Mind‐body exercises, especially tai chi and dance mind‐body exercise, are beneficial for improving global cognition, cognitive flexibility, working memory, verbal fluency, and learning in cognitively intact or impaired older adults. Moderate intensity is recommended as the optimal dose for older adults. J Am Geriatr Soc 67:749–758, 2019.

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Section: Discussionmentioning

confidence: 99%

Section: Findings In Relation To Previous Reviewsmentioning

confidence: 99%

Effects of Mind‐Body Exercises on Cognitive Function in Older Adults: A Meta‐Analysis

Zheng

et al. 2018

J American Geriatrics Society

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“…At least two systematic reviews state that physical activity is one of the seven modifiable risk factors for cognitive impairment in the elderly [5,8]. Evidence-based studies show that physical activity and sedentary behaviour play an important role in cognitive function in older adults [9]. However, some studies have reported associations between physical activity and cognition cross-sectionally [10,11] and longitudinally [12].…”

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confidence: 99%

Relationships of accelerometer-based measured objective physical activity and sedentary behaviour with cognitive function: a comparative cross-sectional study of China’s elderly population

Wang

Hu³

et al. 2020

BMC Geriatr

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Background: This study explored the effects of physical activity and sedentary behaviour on the decline of cognitive ability among the elderly. To compensate for the limitations of self-reported physical activity, objective measures were used. Methods: A cross-sectional survey of 308 aged people mean 68.66 ± 5.377 years, in Nanjing, China, was conducted. Physical activity was measured using the ActiGraph GT3X+, and cognitive function was measured using the Montreal Cognitive Assessment. Results: The overall participant model, adjusted for age, BMI, education, and monthly average income, found that light physical activity (β = 0.006, p < 0.01), moderate-vigorous physical activity (β = 0.068, p < 0.001), and total physical activity (β = 0.006, p < 0.01) had a significant linear relationship with cognitive ability, while sedentary time did not (β = − 0.020, p>0.05). Further, light physical activity only affects the cognitive ability of elderly females (β = 0.006, p < 0.05). There was an inverted 'U' association between moderate-vigorous physical activity and cognitive ability. The association models found that moderate-vigorous physical activity in the 22.13 min·day − 1~3 8.79 min·day − 1 range affected cognitive ability most beneficially, with the highest beta coefficient among all groups (β = 0.091, p < 0.05). Conclusions: While physical activity can significantly improve cognitive ability among the elderly, sedentary behaviour is associated with decreased cognitive function across genders.

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“…Longitudinal studies suggest older sedentary adults who maintain an exercise program for at least 6 months perform better on measures on processing speed, executive function, and memory . A meta‐analysis by Gheysen et al found that physical activity combined with cognitive activities resulted in significantly larger gains in cognition as compared to physical activity alone, suggesting a combination of physical activity and cognitive exercises are perhaps the most effective modality for preventing cognitive decline in older adults …”

Section: Improving Cognition With Exercise and Physical Activitymentioning

confidence: 99%

The importance of physical function as a clinical outcome: Assessment and enhancement

Oneill

Forman

2019

Clinical Cardiology

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The burgeoning population of older adults is intrinsically prone to cardiovascular disease (CVD) in a context of multimorbidity and geriatric syndromes. Risks include high susceptibility to functional decline, with many older adults tipping towards patterns of sedentary behavior and to downstream effects of frailty, falls, disability, poor quality of life, as well as increased morbidity and mortality even if the incident CVD was treated perfectly. While physical activity has been shown to moderate these patterns both as primary or secondary preventive medical care, the majority of older adults fail to meet physical activity recommendations. Clinicians of all specialities, including CVD medicine, can benefit from greater proficiency in functional assessments for their older adults, as well as from insights how to initiate effective functional enhancing approaches even in older adults who may be frail, deconditioned, and medically complex. Pertinent functional assessments include traditional cardiovascular metrics of cardiorespiratory fitness, as well as strength and balance. This review summarizes the components of a wide‐ranging functional assessment that can be used to enhance care for older adults with CVD, as well as interventions to improve physical function.

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Physical activity to improve cognition in older adults: can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis

Cited by 222 publications

References 75 publications

Effects of Mind‐Body Exercises on Cognitive Function in Older Adults: A Meta‐Analysis

Effects of Mind‐Body Exercises on Cognitive Function in Older Adults: A Meta‐Analysis

Relationships of accelerometer-based measured objective physical activity and sedentary behaviour with cognitive function: a comparative cross-sectional study of China’s elderly population

The importance of physical function as a clinical outcome: Assessment and enhancement

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