The impact of physical activity on blood inflammatory cytokines and neuroprotective factors in individuals with mild cognitive impairment: a systematic review and meta-analysis of randomized-controlled trials

Objective. A systematic review with a meta-analysis explored effects of cognitively loaded physical activity interventions on global cognition in community-dwelling older adults (≥65 years of age) experiencing mild cognitive impairment (MCI), compared to any control. Methods. A literature search was conducted in 4 databases (MEDLINE [OvidSP], PubMed, CINAHL, and the Cochrane Central Register of Controlled Trials [Wiley]) from inception until January 30, 2018. The meta-analysis was conducted with Review Manager 5.3. Results. Six randomized controlled trials (RCTs) with 547 participants were identified. The interventions ranged from 4 to 52 weeks. Baseline and initial follow-up assessments were used. The primary pooled analysis of all RCTs demonstrated a nonsignificant trivial effect (standardized mean difference [SMD] 0.07, 95% confidence interval [CI] −0.44 to 0.58) favoring the intervention. In pooled subanalysis of 4 RCTs (n = 405) using the same global cognition measure (Mini-Mental State Examination) and duration of intervention >12 weeks, the intervention group achieved a small but significant improvement for global cognition (SMD 0.45, 95% CI 0.14 to 0.75). Conclusion. When all the RCTs were pooled, the effect of cognitively loaded physical activity intervention on global cognitive function in older adults with MCI remained unclear. The subgroup analysis provides translation evidence for future RCT study designs.

Download Full-text

Effectiveness of Combined Cognitive and Physical Interventions to Enhance Functioning in Older Adults With Mild Cognitive Impairment: A Systematic Review of Randomized Controlled Trials

The Gerontologist ◽

10.1093/geront/gnz149 ◽

2019 ◽

Vol 60 (8) ◽

pp. e633-e642 ◽

Cited By ~ 8

Author(s):

Chenchen Yang ◽

Ami Moore ◽

Elias Mpofu ◽

Diana Dorstyn ◽

Qiwei Li ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Randomized Controlled Trials ◽

Processing Speed ◽

Controlled Trials ◽

Positive Effects ◽

Randomized Controlled

Abstract Background and Objectives Cognitive training delivered in conjunction with physical activity, may help to optimize aging and delay or prevent dementia in individuals with mild cognitive impairment (MCI). However, their efficacy is less well studied compared to pharmaceutical treatments. This systematic review synthesizes the emerging evidence on combined cognitive-physical interventions for enhancing functioning in older adults with MCI, with implications for practice and research. Research Design and Methods We searched the PubMed, PsycINFO, Ageline, Medline, Web of Science and ProQuest databases, and hand-searched articles published between July 2013 and November 2018. Only randomized controlled trials which incorporated cognitive and physical components targeted to individuals with MCI over the age of 50 were eligible. Our search yielded 10 eligible, independent articles. Results Intervention participants with MCI self-reported, or demonstrated, improved functioning across a range of cognitive (global cognitive function, executive function, processing speed, memory, attention, mood, emotion, motivation, brain cortex, orientation), and physical (gait, balance, mobility) outcomes. Interventions which combined cognitive-physical training were comparable to those which isolated these same elements, in terms of their effects on executive function, processing speed, attention, mood, and cardiorespiratory fitness. Discussion and Implications There is preliminary evidence to support the positive effects of multicomponent interventions to improve cognitive-motor abilities in older adults at risk of developing dementia. The strength of this research evidence is, however, limited. Longitudinal studies are needed to determine whether these effects are maintained over time. The optimal intervention intensity and length also need to be established.

Download Full-text