RESUMEN
The meta-analysis aimed to determine whether exercise training can positively change indices of motor drive, i.e., the input from the central nervous system to the muscle, and how training characteristics, motor drive assessment, assessed muscle, and testing specificity could modulate the changes in motor drive in older adults. A random-effect meta-analysis model using standardized mean differences (Hedges' g) determined treatment effects. Moderators (e.g., training type and intensity) and meta-regressors (e.g., number of sessions) were performed using mixed- and fixed-effect models. A significant Q-test, followed by pairwise post hoc comparisons, determined differences between levels of the categorical moderators. Methodological quality was assessed using the Cochrane risk of bias tool. Ten randomized controlled trials, 290 older adults, met the inclusion criteria. Only strength and power exercise training were retrieved from the search and included in the analysis. Strength (g = 0.60, 95 % CI 0.24 to 0.96) and power training (g = 0.51, 95 % CI 0.02 to 1.00) increased motor drive compared with a control condition. High (g = 0.66; 95 % CI 0.34 to 0.97) and low-high (g = 1.23; 95 % CI 0.19 to 2.27) combinations of training intensities increased motor drive compared to the control condition. The multi-joint training and testing exercise structure (g = 1.23; 95 % CI 0.79 to 1.67) was more effective in increasing motor drive (Qdf=2 = 14.15; p = 0.001) than the multi-single joint structure (g = 0.46; 95 % CI 0.06 to 0.85). Therefore, strength and power training with high volume and intensity associated with multi-joint training and testing combination of exercises seem to improve skeletal muscle motor drive in older adults effectively.
Asunto(s)
Músculo Esquelético , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Anciano , Músculo Esquelético/fisiología , Entrenamiento de Fuerza/métodos , Fuerza Muscular/fisiología , Ejercicio Físico/fisiología , Terapia por Ejercicio/métodosRESUMEN
OBJECTIVE: Provide a synthesis of the current literature about the effects of detraining on cognitive functions in older adults. METHODS: The PICOS acronym strategy was performed in PubMed/MEDLINE, Web of Science, Cochrane Library and PsycINFO database. The Preferred Reporting Items for Systematic Review and Meta-Analyses statement had been followed in the present study, in which the search was conducted on October 2023. The study selection consisted in original articles including older adults, detraining after training exercise period, use of tests or scales to measure cognitive function. The Downs and Black checklist had been used to assess the studies quality. Sample characteristics, type of previous training, detraining period, cognitive functions measurements and main results were extracted by 2 investigators. RESULTS: From 1927 studies, 12 studies were included, being 11 studies identified via systematic research, and 1 study by citation search. Older adults, ranged from 60 to 87 years old, were assessed after detraining. The cognitive functions most evaluated were global cognition and executive functions. One study evaluated both cognitive outcome and cerebral blood flow. Most of the studies demonstrated a decline in the cognitive function after detraining. CONCLUSION: Exercise detraining period, ranging from 10 days to 16 weeks, can effect negatively the cognitive function in older adults.
Asunto(s)
Cognición , Ejercicio Físico , Humanos , Anciano , Cognición/fisiología , Ejercicio Físico/psicología , Ejercicio Físico/fisiología , Anciano de 80 o más Años , Función Ejecutiva/fisiología , Persona de Mediana Edad , Disfunción CognitivaRESUMEN
Abstract Aim: The objective of this study was to compare the global cognitive function and depressive symptoms in hypertensive and/or diabetic middle-aged and elderly women (52-76 years old). Methods: Sixteen participants with hypertension (HT) and 12 with hypertension and type 2 diabetes mellitus (HT+DM) were included; sociodemographic data, anthropometric measurements, and blood pressure were analyzed, and questionnaires for cognitive screening (Mini-Mental State Examination - MMSE) and depressive symptoms (Geriatric Depression Scale - GDS-30) were administered. For statistical analysis, independent Student's t-test, chi-square test (dichotomous variables), and the Mann-Whitney test (ordinal variables) were used and p < 0.05 was adopted. Results: Results indicate that there were no significant differences pertaining to depressive symptoms (HT = 7.4 ± 5.5; HT+DM = 10.2 ± 4.6 points; p = 0.1658) and global cognitive function (HT = 22.3 ± 4.2; HT+DM = 21.0 ± 3.2 points; p = 0.4015) between hypertensive women and hypertensive and diabetic women, contradicting the hypothesis that the presence of two comorbidities would intensify cognitive impairment and mental health. However, clinically relevant cognitive decline (HT = 63%; HT+DM = 75%; χ2 = 0.4834) and depressive symptoms (HT = 38%; HT+DM = 33%; χ2 = 0.8199) were found in both groups. Conclusion: It has been shown that the presence of two comorbidities: type 2 diabetes mellitus and hypertension, does not intensify cognitive impairment and mental health when compared to hypertension alone in middle-aged and elderly women.
Asunto(s)
Femenino , Persona de Mediana Edad , Anciano , Cognición , Depresión , Diabetes Mellitus Tipo 2/fisiopatología , Hipertensión/fisiopatología , Estudios TransversalesRESUMEN
ABSTRACT One of hypothetical mechanisms related to cognition is exercise-induced IGF-1. Objective: The aim of this study was to analyze the effects of exercise on IGF-1 levels and cognition in the elderly. Methods: The article searches were conducted on Pubmed, Web of Science, PsycINFO and Scielo databases and reviewed according to PRISMA guidelines. The inclusion criteria were: [1] original articles published up to 2017; [2] samples including elderly; [3] protocols including physical exercise; [4] longitudinal studies having exercise as main outcome; [5] assessment of IGF-1; [6] cognition assessment. Results: Seven studies were included in this review. Three of the studies showed an exercise-induced increase in IGF-1; three found stable IGF-1 levels and one found a reduction in IGF-1; with and without improvement in cognition. Conclusion: Disparities in the type of physical exercise, protocols and samples under different conditions hinder the establishment of a consensus on IGF-1, cognition and physical exercise.
RESUMO. Um dos mecanismos hipotéticos relacionados a cognição é o IGF-1 induzido pelo exercício. Objetivo: O objetivo deste estudo foi analisar os efeitos do exercício físico nos níveis de IGF-1 e na cognição de idosos. Métodos: A busca de artigos foi conduzida nas bases de dados Pubmed, Web of Science, PsycINFO e Scielo, revisada de acordo com as recomendações do PRISMA. O critério de inclusão adotado foi: [1] artigos originais publicados até 2017; [2] amostras incluindo idosos; [3] protocolos que incluíssem exercício físico; [4] ensaios randomizados, não randomizados, controlados e não controlados; [5] avaliação dos níveis de IGF-1; [6] avaliação cognitive. Resultados: Sete estudos foram incluídos nesta revisão. Três deles mostraram aumento de IGF-1 por meio do exercício; três verificaram manutenção nos níveis de IGF-1 e um, verificou redução de IGF-1; com e sem melhora cognitive. Conclusão: Diferenças nos tipos de exercício, protocolos, amostras em diferentes condições dificultam o estabelecimento de um consenso em relação ao IGF-1, cognição e exercício físico.
Asunto(s)
Humanos , Envejecimiento Cognitivo , Anciano , Factor I del Crecimiento Similar a la Insulina , Ejercicio FísicoRESUMEN
A prática regular de atividade física é indicada como uma terapia não farmacológica ao tratamento da doença de Alzheimer por promover benefícios cognitivos, comportamentais e funcionais. Pouco se sabe, porém, sobre os protocolos com intervenção motora domiciliar para essa população. Pensando nisso, esta revisão teve como objetivo investigar e analisar os protocolos de intervenção motora domiciliar para idosos com doença de Alzheimer descritos em artigos científicos. Realizou-se busca sistemática, sem limite de data, nas seguintes bases de dados: Web of Science, PubMed, PsycINFO e Scopus. Utilizaram-se os seguintes operadores booleanos e palavras-chave: "home-based exercise" OR "home-based physical exercise" OR "home-based physical fitness" OR "home-based rehabilitation" OR "home-based physical therapy" OR "home-based physical activity" OR "home-based motor intervention" and "AD" OR "Alzheimer's disease" OR "Alzheimer" OR "Alzheimer's dementia". Realizou-se também uma busca manual nas listas de referência dos artigos selecionados. Dos cinco artigos que atenderam aos critérios de inclusão adotados, três realizaram um protocolo de intervenção motora domiciliar, conseguindo boa adesão ao programa, melhora geral da saúde e diminuição de sintomas depressivos. Os outros dois estudos limitaram-se a descrever os protocolos. Apesar de serem necessários mais estudos, com protocolos mais detalhados, esta revisão permitiu mostrar que protocolos de intervenção motora domiciliar também podem produzir efeitos positivos tanto para pacientes quanto para cuidadores.
The regular practice of physical therapy is indicated as a non-pharmacological treatment of Alzheimer's disease by promoting cognitive, behavioral and functional benefits. However, little is known about the protocols with home-based motor intervention for this population. Thinking about it, this review aimed to investigate and analyze the protocols for home-based motor intervention for elderly with Alzheimer's disease described in scientific articles. A systematic search was performed in the following databases: Web of Science, PubMed, PsycINFO, and Scopus, using the following keywords and Boolean operators: "home-based exercise" OR "home-based physical exercise" OR "home-based physical fitness" OR "home-based rehabilitation" OR "home-based physical therapy" OR "home-based physical activity" OR "home-based engine Intervention" and "AD" OR "Alzheimer's disease" OR "Alzheimer " OR "Alzheimer's dementia". We also conducted a manual search of reference lists of selected articles. Of the five articles that met the inclusion criteria adopted, three performed a protocol for home motor intervention, achieving good compliance with the program, improvement of general health and reduction of depressive symptoms. The other two studies were limited to describing the protocols. Although more studies are needed, with detailed protocols, this review allowed to show that protocols for home motor intervention can also produce positive effects for both patients and caregivers.
RESUMEN
The aims of this study were to characterize the presence of apathy in patients with AD, determine the relationshipbetween apathy, motor function and cognitive function, and to verify differences among patients stratified by level of apathy inrelation to cognitive and motor abilities. Methods: A cross-sectional study was conducted of 37 patients with AD. The followingtests were used: MoCA, the Frontal Assessment Battery, Verbal Fluency, Clock Drawing Test, Andreotti & Okuma BatteryTests, Sit and Reach, Resistance of Upper Limbs - AAHPERD Battery Test, Sit and Lift Chair and the Apathy domain of theNeuropsychiatric Inventory. After verifying the normality of the data distribution, comparisons were made using Students t-testand the U Mann Whitney test; relationships were also assessed using Pearsons and Spearmans correlation coefficients. Allanalyses were considered to be statistically significant at a p-value of 0.05. Results: 46% of participants in this study showedmild symptoms of apathy. Significant and weak associations were found (p=0.04) between apathy and the attention domainon the MoCA and between apathy and the Walk Test. Analysis of differences in cognitive and motor functions according toparticipants level of apathy revealed no significant differences for any of the variables. Conclusion: Apathy was reflectedin attention and the Walk Test, suggesting these variables may be related to cognitive and functional decline in AD patients.
Os objetivos deste estudo compreendem: caracterizar a presença de apatia em pacientes com doença de Alzheimer(DA); verificar se há relação entre apatia, funções cognitivas e funcionalidade motora dos mesmos e analisar se há diferençasentre os pacientes, separados por nível de apatia, em relação às suas funções cognitivas e funcionalidade motora. Métodos:Trata-se de um estudo com delineamento transversal. Ao todo 37 pacientes com DA compuseram a amostra. Foramutilizados os seguintes testes: Mini-Exame de Estado Mental, Montreal Cognitive Assessment (MoCA), Bateria de AvaliaçãoFrontal, Teste de Fluência Verbal Semântica, Teste do Desenho do Relógio, Bateria de Testes de Andreotti & Okuma, Teste deSentar e Alcançar, Resistência de Membros Superiores da AAHPERD, Teste Sentar-se e Levantar-se da Cadeira e o domínioApatia do Inventário Neuropsiquiátrico. Após verificar a distribuição dos dados as comparações seguiram através dos testest student e U Mann Whitney e as relações, através das correlações de Pearson e Spearman. Todas as análises admitiramnível de significância de 5%. Resultados: 46% dos participantes deste estudo apresentam sintomatologia para apatia emnível leve. Foram verificadas relações significativas e fracas (p=0,04) entre apatia e o domínio atenção do MoCA e entreapatia e o Teste de Caminhar. Ao verificar a diferença nas funções cognitivas e funcionalidade motora segundo o nível deapatia dos participantes não foram encontradas diferenças significativas para nenhuma das variáveis analisadas. Conclusão:Apatia relaciona-se com a atenção e o Teste de Caminhar sugerindo que estas variáveis podem estar relacionadas com odeclínio cognitivo e funcional dos pacientes com esta patologia.
Asunto(s)
Cognición , Apatía , Enfermedad de Alzheimer , Actividad MotoraRESUMEN
Deterioration in cognitive functions is characteristic in Alzheimers disease (AD) and may be associated with decline in daily living activities with consequent reduced quality of life. Objective: To analyze weight training effects oncognitive functions in elderly with AD. Subjects: 34 elderly with AD were allocated into two groups: Training Group (TG)and Social Gathering Group (SGG). Methods: Global cognitive status was determined using the Mini-Mental State Exam.Specific cognitive functions were measured using the Brief Cognitive Battery, Clock Drawing Test and Verbal Fluency Test.The protocols were performed three times a week, one hour per session. The weight training protocol consisted of threesets of 20 repetitions, with two minutes of rest between sets and exercises. The activities proposed for the SGG were not systematized and aimed at promoting social interaction among patients. The statistical analyses were performed with the UMann Whitney and Wilcoxon tests for group comparisons. All analyses were considered statistically significant at a p-value of0.05. Results: There were no significant differences associated to the effects of the practice of weight training on cognitionin AD patients. Conclusion: In this study, no improvement in cognitive functions was evident in elderly with AD who followeda low intensity resistance exercise protocol. Thus, future studies could evaluate the effect of more intense exercise programs.
A deterioração das funções cognitivas é característica na doença de Alzheimer (DA) e se relaciona com uma piorrealização das atividades de vida diária levando a uma pior qualidade de vida. Objetivo: Analisar os efeitos de um programade treinamento com pesos nas funções cognitivas de idosos com DA. Sujeitos: 34 idosos com DA foram alocados em dois grupos: Grupo Treinamento (GT) e Grupo de Convívio Social (GCS). Métodos: Para caracterização do perfil cognitivo global utilizou-se o Mini-Exame de Estado Mental. Para a mensuração das funções cognitivas foram utilizadas: Bateria Cognitiva Breve, Teste do Desenho do Relógio e teste de Fluência Verbal. Os protocolos oferecidos foram realizados três vezes na semana, durante uma hora. O protocolo de treinamento do GT consistiu em realizar três séries de 20 repetições para cada exercício, com dois minutos de intervalo entre séries e entre exercícios. As atividades propostas para o GCS não foram sistematizadas e tiveram por objetivo promover uma socialização dos pacientes. A análise estatística consistiu na utilização dos testes U Mann Whitney e Wilcoxon para comparação intra e entre grupos. Adotou-se nível de significância de 5% para todas as análises. Resultados: Não foram evidenciadas diferenças significativas relacionadas aos efeitos da prática do treinamento com pesos na cognição de idosos com DA. Conclusão: Neste estudo não houve melhora nas funções cognitivas em idosos com DA que realizaram um protocolo de exercícios resistidos de intensidade leve. Assim, estudos futuros poderiam verificar o efeito de exercícios mais intensos.
Asunto(s)
Humanos , Cognición , Enfermedad de AlzheimerRESUMEN
A atividade física (AF) tem sido considerada um importante recurso não farmacológico, que pode proporcionar benefícios ao sono e à qualidade de vida de pacientes com Doença de Alzheimer (DA). O presente estudo teve por objetivo analisar a relação entre nível de atividade física, distúrbios do sono e qualidade de vida em pacientes com DA. Participaram deste estudo 30 pacientes com DA. Para mensurar nível de AF, sono e qualidade de vida foram utilizados, respectivamente: Questionário Baecke Modificado para Idosos, Mini Questionário do Sono e Escala de avaliação da qualidade de vida na Doença de Alzheimer ? respondida pelo paciente e cuidador. Para comparação do sono e da qualidade de vida, em função do nível da prática de AF, a amostra foi dividida em dois grupos (maior e menor nível de AF). Para verificar relações entre as variáveis e comparar os grupos foram empregados, respectivamente, os seguintes testes: correlação de Spearman e o teste de U de Mann Whitney. Foi admitido o nível de significância de 5% para as análises. Os pacientes apresentaram um baixo nível de AF e foi encontrada relação positiva, moderada e significativa (rho = 0,4; p = 0,01) entre nível de AF e qualidade de vida do cuidador. Concluímos, assim, que cuidadores de pacientes mais ativos possuem uma melhor qualidade de vida e não existe relação entre sono e qualidade de vida e nível de AF de pacientes com DA.
Physical activity (PA) has been considered an important non pharmacological feature that provides benefits on sleeping and quality of life of patients with Alzheimer?s disease (AD). The aim of this research was to analyze the relation of the level of PA; sleep disturbances and quality of life in pacients with AD. The study included 30 patients with PA. To measure PA level, sleeping and quality of life, it was used, respectively: Modified Baecke Questionnaire for the Elderly, Mini Sleep Questionnaire and Quality of life assessment scale on Alzheimer?s disease ? answered by the patients and their caregivers. For comparçliing of sleeping and quality of life, the sample was divided into two groups (higher and lower PA levels). In order to verify relations between the variables, and for the comparison both groups, it was used, respectively: Spearman correlation and U-Mann Whitney tests. It was admitted the level of significance at 5% for all analyzes. Patients had a low level of PA and it was only found relationship positive, moderated and significant (rho = 0,4; p = 0,01) between the level of PA and the caregiver?s quality of life. Thus, the caregivers of more active patients have a better quality of life and, there were no differences in sleep and quality of life when comparing the lowest and the highest level of PA groups of patients with AD.
Asunto(s)
Humanos , Masculino , Femenino , Anciano , Enfermedad de Alzheimer/patología , Calidad de VidaRESUMEN
Devido ao aumento da expectativa de vida mundial é cada vez maior o número de idosos com Demências, sendo a mais frequente a Demência de Alzheimer, uma doença neurodegenerativa e progressiva. O "Programa de Cinesioterapia Funcional e Cognitiva em Idosos com Doença de Alzheimer" (PRO-CDA) procura, através da prática de Atividade Física, interferir nos sintomas progressivos da doença, proporcionando, sobretudo a promoção de saúde para idosos e seus cuidadores. Por meio do trabalho de uma equipe multiprofissional, com profissionais de saúde e estagiários de cursos de graduação, o projeto desenvolve atividades para benefício dos participantes, eventos para conscientização da população a respeito da doença e aprimoramento de profissionais e estudantes da área da saúde. Assim, o PRO-CDA espera contribuir com melhora da qualidade de vida, tanto do paciente como do cuidador, além de contribuir com a formação profissional de estudantes e graduados nas mais diversas áreas da saúde.
Due to increased life expectancy worldwide is increasing the number of elderly with dementia, the most frequent being Alzheimer's dementia, a progressive and neurodegenerative disease. "The Cinesioterapy Cognitive and Functional Program in elderly with Alzheimer's Disease" (PRO-CDA) looking for, through the practice of physical activity, to intervene in symptoms of progressive disease, providing over all promotion of health for elderly and their caregivers. Through the work of multidisciplinary team, with health professionals and trainees from undergraduate courses, the project develops activities to benefit the participants, events for public awareness about the disease and improvement of professional and student health. So, the PRO-CDA hopes to contribute for improved quality of life, both of patients as the caregivers, as well contributing to the training of students and graduates in various areas of health.