An Overview of the Cardiorespiratory Hypothesis and Its Potential Contribution to the Care of Neurodegenerative Disease in Africa.

One hypothesis that could explain the beneficial effects of physical exercise on cognitive function is the cardiorespiratory hypothesis. This hypothesis proposes that improved cognitive functioning may be in part a result of the physiological processes that occur after physical exercise such as: Increased cerebral perfusion and regional cerebral blood flow. These processes ensure increased oxygenation and glucose transportation to the brain, which together can improve cognitive function. The objective of this narrative review is to examine the contribution of this hypothesis in the care of African older adults with neurodegenerative conditions (i.e., dementia (Alzheimer's disease)) or with mild cognitive impairments. Although studies in developed countries have examined people of African descent (i.e., with African Americans), only the limited findings presented in this review reflect how these conditions are also important for the African continent. This review revealed that no studies have examined the effects of cardiorespiratory fitness on neurodegenerative disease in Africa. African nations, like many other developing countries, have an aging population that is growing and will face an increased risk of neurodegenerative declines. It is therefore imperative that new research projects be developed to explore the role of the cardiorespiratory fitness in neurodegenerative disease prevention in African nations.

Processing speed and executive functions in cognitive aging: how to disentangle their mutual relationship?

The processing-speedtheory and the prefrontal-executivetheory are competing theories of cognitive aging. Here we used a theoretically and methodologically-driven framework to investigate the relationships among measures classically used to assess these two theoretical constructs. Twenty-eight young adults (18-32 years) and 39 healthy older adults (65-80 years) performed a battery of nine neuropsychological and experimental tasks assessing three executive function (EF) components: Inhibition, Updating, and Shifting. Rate of information processing was evaluated via three different experimental and psychometric tests. Partial correlations analyses suggested that 2-Choice Reaction Time (CRT) performance is a more pure measure of processing speed than Digit Symbol Substitution Test (DSST) performance in the elderly. Hierarchical regression analyses showed that, although measures of processing speed and EF components share mutual variance, each measure was independently affected by chronological age. The unique adverse effect of age was more important for processing speed than for EF. The processing-speed theory and the prefrontal-executive theory of cognitive aging were shown not to be mutually exclusive but share mutual variance. This implies the need to control for their mutual relationship before examining their unique potential role in the explanation of age-related cognitive declines. Caution has still to be taken concerning the tasks used to evaluate these theoretical constructs.

Impact of physical activity on executive functions in aging: a selective effect on inhibition among old adults.

The purposes of this study were to determine the impact of physical activity on three different executive functions (shifting, inhibition, and updating) and to examine whether cardiovascular fitness was a good mediator of the positive link(s) between these variables. Sixty-three young adults (18-28 years), 30 young-old adults (60-70 years) and 30 old adults (71-81 years) were divided into physically active and sedentary groups according to physical activity level (assessed from an accelerometer and the Historical Leisure Activity Questionnaire). Cardiovascular fitness was assessed by VO2max from the Rockport 1 mile. Each executive function was assessed through three different experimental tasks. ANCOVAs revealed that the effect of physical activity level was specific to the old adults and significant for inhibition, but not for updating and shifting. Mediation analysis showed that this positive effect in the old adults group was mediated by cardiovascular fitness level. The present findings highlight the positive linkages among physical activity, cardiovascular fitness, and inhibition in aging.

Load-Dependent Prefrontal Cortex Activation Assessed by Continuous-Wave Near-Infrared Spectroscopy during Two Executive Tasks with Three Cognitive Loads in Young Adults.

The present study examined the evolution of the behavioral performance, subjectively perceived difficulty, and hemodynamic activity of the prefrontal cortex as a function of cognitive load during two different cognitive tasks tapping executive functions. Additionally, it investigated the relationships between these behavioral, subjective, and neuroimaging data. Nineteen right-handed young adults (18-22 years) were scanned using continuous-wave functional near-infrared spectroscopy during the performance of n-back and random number generation tasks in three cognitive load conditions. Four emitter and four receptor optodes were fixed bilaterally over the ventrolateral and dorsolateral prefrontal cortices to record the hemodynamic changes. A self-reported scale measured the perceived difficulty. The findings of this study showed that an increasing cognitive load deteriorated the behavioral performance and increased the perceived difficulty. The hemodynamic activity increased parametrically for the three cognitive loads of the random number generation task and in a two-back and three-back compared to a one-back condition. In addition, the hemodynamic activity was specifically greater in the ventrolateral prefrontal cortex than in the dorsolateral prefrontal cortex for both cognitive tasks (random number generation and n-back tasks). Finally, the results highlighted some links between cerebral oxygenation and the behavioral performance, but not the subjectively perceived difficulty. Our results suggest that cognitive load affects the executive performance and perceived difficulty and that fNIRS can be used to specify the prefrontal cortex's implications for executive tasks involving inhibition and working memory updating.

Increased heart rate variability and executive performance after aerobic training in the elderly.

This study examined the effects of two short physical training programs on various parameters of heart rate variability (HRV) and on executive performance in older people. Twenty-four sedentary men and women aged 65-78 years were randomly assigned to an aerobic exercise program or a stretching program three times a week for 12 weeks. Resting HRV was measured in time and frequency domains in each participant before and after the 12-week programs. Executive performance was measured with the Wisconsin card sorting test (WCST). Significant group-session interactions emerged for the standard deviation of normal beat-to-beat (R-R) intervals, the root-mean-square of successive R-R, and high frequency power. Only the aerobic training group increased vagal-mediated HRV parameters. Moreover, only the participants in the aerobic training group improved their performance on the WCST. These results highlight the role of aerobic exercise as an important cardiac and brain protective factor, and suggest a direct link between exercise, HRV, and cognition in the aged population.

Working Memory, Cognitive Load andCardiorespiratory Fitness: Testing the CRUNCHModel with Near-Infrared Spectroscopy.

The present study aimed to examine the effects of chronological age and cardiorespiratory fitness (CRF) on cognitive performance and prefrontal cortex activity, and to test the compensation-related utilization of neural circuits hypothesis (CRUNCH). A total of 19 young adults (18⁻22 years) and 37 older ones (60⁻77 years) with a high or low CRF level were recruited to perform a working memory updating task under three different cognitive load conditions. Prefrontal cortex hemodynamic responses were continuously recorded using functional near-infrared spectroscopy, and behavioral performances and perceived difficulty were measured. Results showed that chronological age had deleterious effects on both cognitive performance and prefrontal cortex activation under a higher cognitive load. In older adults, however, higher levels of CRF were related to increased bilateral prefrontal cortex activation patterns that allowed them to sustain better cognitive performances, especially under the highest cognitive load. These results are discussed in the light of the neurocognitive CRUNCH model.

The impact of physical activity and sex differences on intraindividual variability in inhibitory performance in older adults.

It is well-known that processing speed and executive functions decline with advancing age. However, physical activity (PA) has a positive impact on cognitive performances in aging, specifically for inhibition. Less is known concerning intraindividual variability (iiV) in reaction times. This study aims to investigate the influence of PA and sex differences on iiV in inhibitory performance during aging. Healthy adults were divided into active and sedentary groups according to PA level. To analyse iiV in reaction times, individual mean, standard deviation and the ex-Gaussian parameters were considered. An interaction between activity level and sex was revealed, sedentary females being slower and more variable than sedentary men. No sex differences were found in the active groups. These results indicate that the negative impact of sedentariness on cognitive performance in older age is stronger for females. The present findings underline the need to consider sex differences in active aging approaches.

Use of near-infrared spectroscopy in the investigation of brain activation during cognitive aging: A systematic review of an emerging area of research.

The cognitive neuroscience of aging is a growing and stimulating research area. The development of neuroimaging techniques in the past two decades has considerably increased our understanding of the brain mechanisms that might underlie cognitive performance and resulting changes due to normal aging. Beside traditional metabolic neuroimaging techniques, such as Positron Emission Tomography and functional Magnetic Resonance Imaging, near infrared spectroscopy (NIRS), an optical imaging technique allowing to monitor real-time cerebral blood oxygenation, has gained recent interest in this field. The aim of the present review paper, after briefly presenting the NIRS technique, is to review and to summarize the recent results of neuroimaging studies using this technique in the field of cognitive aging. The reviewed literature shows that, despite low spatial resolution and cerebral depth penetration, this technique provides consistent findings on the reduced hemodynamic activity as a function of chronological age, mainly in the prefrontal cortex. Important moderators of brain hemodynamics, such as cognitive load, subjects' characteristics and experimental conditions, for which the NIRS technique is sensitive, are discussed. Strengths and weaknesses of functional NIRS in the field of cognitive aging are presented and finally, novel perspectives of research are proposed.

Interaction between BDNF Polymorphism and Physical Activity on Inhibitory Performance in the Elderly without Cognitive Impairment.

Background: In the elderly, physical activity (PA) enhances cognitive performances, increases brain plasticity and improves brain health. The neurotrophic hypothesis is that the release of brain-derived neurotrophic factor (BDNF), which is implicated in brain plasticity and cognition, is triggered by PA because motoneurons secrete BDNF into the bloodstream during exercise. Individual differences in cognitive performance may be explained by individual differences in genetic predisposition. A single nucleotide polymorphism on the BDNF gene, BDNFVal66Met, affects activity-dependent BDNF secretion. This study investigated the influence of the BDNFVal66Met polymorphism on the relationship between PA and controlled inhibition performance in older adults. Methods: A total of 114 healthy elderly volunteers (mean age = 71.53 years old) were evaluated. Participants were genotyped for the BDNFVal66Met polymorphism. We evaluated inhibitory performance using choice reaction times (RT) and error rates from a Simon-like task and estimated their PA using two self-reported questionnaires. We established four groups according to PA level (active vs. inactive) and BDNFVal66Met genotype (Met carriers vs. Val-homozygous). The results were analyzed using ANOVA and ANCOVA, including age, gender and body mass index as covariates. Results: The BDNFVal66Met polymorphism interacted with PA on controlled inhibition performance. More specifically, inactive Val-homozygous participants exhibited a lower inhibition performance than active Val homozygotes and inactive Met carriers; the former had a higher error rate without differences in RT. Conclusion: Differences between individuals on inhibitory performance may be partially understood by the interaction between genetic influence in BDNF secretion and PA level. The results of this study clearly support the neurotrophic hypothesis that BDNF synthesis is an important mechanism underlying the influence of physical activity on brain structure and functions.

Executive functions improvement following a 5-month aquaerobics program in older adults: Role of cardiac vagal control in inhibition performance.

The aims of this study were to examine the effects of aerobic exercise on measures of executive performance and their relationships with changes in cardiorespiratory fitness, cardiac vagal control (heart rate variability) and psychological variables. Thirty-six sedentary seniors aged 60-75 years were randomly assigned to a swimming and aquaerobics program or a stretching program two times a week for 21 weeks. Executive functions (inhibition, updating of working memory and cognitive flexibility) and cardiorespiratory fitness (estimated VO2max) were assessed at the start, after 10 weeks of program and at the end of the program. Resting HRV and measures of psychological outcomes (depression, self-efficacy, decisional balance) were obtained at the start and at the end of the program. Participants of both groups significantly improved their VO2max level, their psychological state and their performance for the 2-back task. Only the participants in the aquaerobics group significantly improved their vagally-mediated HRV and their performance for the Stroop test and the verbal running-span test at the end of the program. Only improvements in cardiac vagal control and in inhibition were shown to be functionally related. These results are discussed in line with the model of neurovisceral integration.

Effects of BDNF polymorphism and physical activity on episodic memory in the elderly: a cross sectional study.

BACKGROUND: The brain-derived neurotrophic factor (BDNF) concentration is highest in the hippocampus compared with that in other brain structures and affects episodic memory, a cognitive function that is impaired in older adults. According to the neurotrophic hypothesis, BDNF released during physical activity enhances brain plasticity and consequently brain health. However, even if the physical activity level is involved in the secretion of neurotrophin, this protein is also under the control of a specific gene. The aim of the present study was to examine the effect of the interaction between physical activity and BDNF Val66Met (rs6265), a genetic polymorphism, on episodic memory. METHODS: Two hundred and five volunteers aged 55 and older with a Mini Mental State Examination score ≥ 24 participated in this study. Four groups of participants were established according to their physical activity level and polymorphism BDNF profile (Active Val homozygous, Inactive Val homozygous, Active Met carriers, Inactive Met carriers). Episodic memory was evaluated based on the delayed recall of the Logical Memory test of the MEM III battery. RESULTS: As expected, the physical activity level interacted with BDNF polymorphism to affect episodic memory performance (p < .05). The active Val homozygous participants significantly outperformed the active Met carriers and inactive Val homozygous participants. CONCLUSION: This study clearly demonstrates an interaction between physical activity and BDNF Val66Met polymorphism that affects episodic memory in the elderly and confirms that physical activity contributes to the neurotrophic mechanism implicated in cognitive health. The interaction shows that only participants with Val/Val polymorphism benefited from physical activity.

Improved cerebral oxygenation response and executive performance as a function of cardiorespiratory fitness in older women: a fNIRS study.

Cardiorespiratory fitness has been shown to protect and enhance cognitive and brain functions, but little is known about the cortical mechanisms that underlie these changes in older adults. In this study, functional near infrared spectroscopy (fNIRS) was used to investigate variations in oxyhemoglobin [HbO2] and in deoxyhemoglobin [HHb] in the dorsolateral prefrontal cortex (DLPFC) during the performance of an executive control task in older women with different levels of cardiorespiratory fitness (VO2max). Thirty-four women aged 60-77 years were classified as high-fit and low-fit based on VO2max measures. They all performed a control counting (CNT) task and the Random Number Generation (RNG) task at two different paces (1 number/1 s and 1 number/1.5 s), allowing to manipulate task difficulty, while hemodynamic responses in the bilateral DLPFCs were recorded using continuous-wave NIRS. The behavioral data revealed that the high-fit women showed significantly better performance on the RNG tasks compared with the low-fit women. The high-fit women showed significant increases in [HbO2] responses in both left and right DLPFCs during the RNG task, while the low-fit women showed significantly less activation in the right DLPFC compared with the right DLPFC of the high-fit women and compared with their own left DLPFC. At the level of the whole sample, increases in the [HbO2] responses in the right DLPFC were found to mediate in part the relationship between VO2max level and executive performance during the RNG task at 1.5 s but not at 1 s. These results provide support for the cardiorespiratory fitness hypothesis and suggest that higher levels of aerobic fitness in older women are related to increased cerebral oxygen supply to the DLPFC, sustaining better cognitive performance.

Sensory-based mechanism for delayed motor intention.

Prospective motor learning (PML) can be defined as learning an action to be performed in the future. The privileged retrieval mechanism behind this delayed motor performance remains unknown. From a motor control and learning perspective, we may conceive of two forms of retrieval: a stimulus- and an intention-based control. Retrieval from intention-based control is based on the anticipation of intended sensory effects related to an action in order to select and control the appropriate motor procedure (i.e., the ideomotor mechanism). In contrast, in a stimulus-based control a connection between stimuli-features and their related action-features is stored in the memory and serves as the retrieval mechanism. In this view, action retrieval from external stimuli is based on the detection of events in the environment to perform the intended behaviour (i.e., the sensorimotor mechanism). In this study, we report an advantage in the action retrieval for participants who use an intention-based mode of control in comparison to a stimulus-based control. Furthermore, a control task reveals that the intention-based advantage is specific to PML. Our findings show that PML is benefited by mental anticipation of a sensory effect that is efficiently processed through an ideomotor mechanism to fulfil delayed motor intentions.

Swimming as a positive moderator of cognitive aging: a cross-sectional study with a multitask approach.

This study examined whether regular swimming in older adults was related to better cognitive functioning and whether there were any global or selective positive effects of this physical activity (PA) on cognition. The cognitive performances of three groups of sixteen volunteer participants (young adults, sedentary older adults, and older adults who regularly practice swimming) were evaluated using a multitask approach. All participants performed a battery of ten tasks: two reaction time tasks assessing information processing speed and eight experimental tasks assessing three executive functions (EFs), (behavioral inhibition, working memory updating, and cognitive flexibility). The results showed that young adults performed significantly better than older adults on all examined cognitive functions. However, in older adults, regular swimming was related to better performance on the three EFs, but not on information processing speed. More precisely, five experimental tasks out of the eight tapping EFs were shown to be sensitive to positive effects from swimming practice. Finally, the demonstrated benefits of swimming on EFs were not necessarily linked to better cardiorespiratory fitness. The present findings illustrate the validity of using a multitask approach in examining the potential benefits of regular PA on cognitive aging.