The effect of group exercises on balance, mobility, and depressive symptoms in older adults with mild cognitive impairment: a randomized controlled trial

Abstract

Objective: To determine the effects of group exercises on balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment. Design: Single blinded, randomized, matched pairs clinical trial. Setting: Four primary healthcare units. Subjects: Fifty-two sedentary subjects with mild cognitive impairment were paired (age, sex, body mass index, and Addenbrooke’s Cognitive Examination Revised score), tested, and then randomized into an intervention group (n = 26) and a control group (n = 26). Intervention: The intervention group performed strength (ankle weights, elastic bands, and dumbbells) and aerobic exercises (walking) in their communities’ public spaces, twice a week (60 minutes each), during 24 weeks. The control group maintained its usual routine. Main measures: Balance (Berg Balance Scale (BBS)), mobility (Timed Up and Go Test (TUG)), and depressive symptoms (Geriatric Depression Scale-15) were assessed before and after the intervention. Results: Before the intervention, the two groups did not differ statistically. After, the intervention group showed significant improvement (P < 0.05) in balance (before: 53 ± 3; after: 55.1 ± 1.1 points), mobility (before: 10.7 ± 2.9 seconds; after: 8.3 ± 2 seconds), and depressive symptoms (median punctuation (interquartile range) before: 4 (1.8–6); after: 2.5 (1–4)). The control group presented a significant increase in their depressive symptoms (median before: 3.5 (2–7.3); after: 4 (2–5.3)), while their balance and mobility showed no significant modification. Small effect sizes were observed in the intervention group and control group depressive symptoms, as well as in the control group’s mobility and balance. Large effect sizes were observed the intervention group’s mobility and balance. Conclusion: Group exercises improved balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment.

Associations Between Depressive Symptoms and Physical Activity Intensity in an Older Adult Population During COVID-19 Lockdown

“…In another study with frail and pre-frail older adults, physical exercise was effective in significantly reducing the depression score ( Ng et al, 2017 ). Langoni et al (2019) developed a 24-weeks intervention with 52 mild cognitively impaired and sedentary older adults. Results demonstrated that the program reduced the median geriatric depression score against the initial value.…”

Postural Control Dysfunction and Balance Rehabilitation in Older Adults with Mild Cognitive Impairment

“…The inception of balance rehabilitation studies in MCI was in the beginning of the last decade (Table 1). There has been an increase in published studies since 2011, with most studies published in 2016 (n = 5) [44,[49][50][51]57] and 2019 (n = 4) [41,43,54,55].…”

“…There were a total of 16 original RCTs [39][40][41][42][43][44]46,47,49,50,53,54,[56][57][58][59]; five studies [45,48,51,52,55] were secondary reports of the 16 RCTs (Table 1). Therefore, in the following sections, the study percentages demonstrating study outcomes and results (Sections 3.1.7 and 3.2) were taken out of the 21 studies, while the study percentages describing other study characteristics (Sections 3.1.3-3.1.6 and 3.1.8) were taken out of the 16 original RCTs.…”

“…The most common intervention paradigms used were combined physical and cognitive intervention (50%, n = 8) [39,41,42,44,46,49,50,56], followed by multimodal physical exercise (25%, n = 4) [43,47,54,56], Tai Chi (13%, n = 2) [53,58], ground kayak paddling exercise (6%, n = 1) [40], dumbbell exercise (6%, n = 1) [57], and elastic-band based exercise (6%, n = 1) [ [44,53,57,58] included three sessions per week, 6% (n = 1) [56] included one to three sessions a week, and the remaining 6% (n = 1) [39] included two to five sessions a week (Table 2). Sixty-three percent (n = 10) [40][41][42][43]47,49,54,56,57,59] had training session durations from 60 to 90 min, and the remaining 38% (n = 6) [39,44,46,50,53,58] had session lengths fewer than 60 min (Table 2). Nineteen percent (n = 3) [44,55,59] designed a progressive increase in intensity during training (Table…”

“…Fifty-two percent (n = 11) of the 21 studies (including both the original RCTs and the secondary reports) used Get-Up and Go (GUG, n = 1) [39] or a modified version Timed Up-and-Go (TUG, n = 9) [40][41][42]46,50,54,56,57,59] or 8-Foot Up and Go (8UG, n = 1) [43] test to measure dynamic balance and agility, which required subjects to stand up from a chair, walk a defined distance and back to the chair, and sit down again. Thirty-eight percent (n = 8) of the studies used functional reach test (FRT) (n = 4) [40,41,55,57], postural sway (n = 2) [41,49], one-leg stance (OLS, n = 2) [41,47], or functional stretching (n = 1) [50] to measure static or dynamic balance during standing under single task.…”