Personalized Exercise Programs Based upon Remote Assessment of Motor Fitness: A Pilot Study among Healthy People Aged 65 Years and Older.

BACKGROUND: The World Health Organization has recently updated exercise guidelines for people aged >65 years, emphasizing the inclusion of multiple fitness components. However, without adequate recognition of individual differences, these guidelines may be applied using an approach that "one-size-fits-all." Within the shifting paradigm toward an increasingly personalized approach to medicine and health, it is apparent that fitness components display a significant age-related increase in variability. Therefore, it is both logical and necessary to perform an accurate individualized assessment of multiple fitness components prior to optimal prescription for a personalized exercise program. OBJECTIVE: The aim of the study was to test the feasibility and effectiveness of a novel tool able to remotely assess balance, flexibility, and strength using smartphone sensors (accelerometer/gyroscope), and subsequently deliver personalized exercise programs via the smartphone. METHODS: We enrolled 52 healthy volunteers (34 females) aged 65+ years, with normal cognition and low fall risk. Baseline data from remote smartphone fitness assessment were analyzed to generate 42 fitness digital markers (DMs), used to guide personalized exercise programs (×5/week for 6 weeks) delivered via smartphone. Programs included graded exercises for upper/lower body, flexibility, strength, and balance (dynamic, static, and vestibular). Participants were retested after 6 weeks. RESULTS: Average age was 74.7 ± 6.4 years; adherence was 3.6 ± 1.7 exercise sessions/week. Significant improvement for pre-/posttesting was observed for 10/12 DMs of strength/flexibility for upper/lower body (sit-to-stand repetitions/duration; arm-lift duration; torso rotation; and arm extension/flexion). Balance improved significantly for 6/10 measures of tandem stance, with consistent (nonsignificant) trends observed across 20 balance DMs of tandem walk and 1 leg stance. Balance tended to improve among the 37 participants exercising ≥3/week. DISCUSSION: These preliminary results provide a proof of concept, with high adherence and improved fitness confirming the benefits of remote fitness assessment for guiding home personalized exercise programs among healthy adults aged >65 years. Further examination of the application within a randomized control study is necessary, comparing the personalized exercise program to general guidelines among healthy older adults, as well as specific populations, such as those with frailty, deconditioning, cognitive, or functional impairment. The study tool offers the opportunity to collect big data, including additional variables, with subsequent utilization of artificial intelligence to optimize the personalized exercise program.

Static Balance Digital Endpoints with Mon4t: Smartphone Sensors vs. Force Plate.

Static balance tests are conducted in various clinics for diagnosis and treatment adjustment. As a result of population aging, the accessibility of these tests should be increased, in the clinic, and for remote patient examination. A number of publications have already conducted static balance evaluations using the sensors embedded in a smartphone. This study focuses on the applicability of using smartphone-based balance assessment on a large scale while considering ease of use, safety, and reliability. The Mon4t® app was used to acquire the postural motion using different smartphone devices, different smartphone locations, and various standing postures. The signals derived from the app were compared to the center of pressure displacement derived from a force plate. The results showed moderate to high agreement between the two methods, particularly at the tandem stance (0.69 ≤ r ≤ 0.91). Preliminary data collection was conducted on three healthy participants, followed by 50 additional healthy volunteers, aged 65+. The results demonstrated that the Mon4t app can serve as an accessible and inexpensive static balance assessment tool, both in clinical settings and for remote patient monitoring, which is key for enabling telehealth.

Predictors of Future Walking Speed: A 12-Month Monitoring Program.

The purpose of the current study was to identify significant predictors of walking speed (WS) among community-dwelling older adults, as it is one of the most representative measures of functioning in their daily lives. Seventy-seven (24 adult men, 26 adult women, and 27 older-adult women) community-dwelling older adults (73.7 ± 4.9 years) performed two assessments, over a 12-month period. Several physical, cognitive, and psychological tests were performed, as well as assessing the preferred WS. Multiple linear regression, stratified by gender, was used to identify significant predictors of future WS. For the adult men, walking and functional performances at the first assessment predicted 71.9%; for adult women, reaction time, walking, and balance performance predicted 64.4%; and, for the older-adult women, fast walking and reaction time predicted 48.2% of the variance of future WS. Clinicians should consider including different exercises for each group of older adults to evaluate and preserve functional abilities.

Personalized multicomponent exercise programs using smartphone technology among older people: protocol for a randomized controlled trial.

BACKGROUND: Optimal application of the recently updated World Health Organization (WHO) guidelines for exercise in advanced age necessitates an accurate adjustment for the age-related increasing variability in biological age and fitness levels, alongside detailed recommendations across a range of motor fitness components, including balance, strength, and flexibility. We previously developed and validated a novel tool, designed to both remotely assess these fitness components, and subsequently deliver a personalized exercise program via smartphone. We describe the design of a prospective randomized control trial, comparing the effectiveness of the remotely delivered personalized multicomponent exercise program to either WHO exercise guidelines or no intervention. METHODS: Participants (n = 300) are community dwelling, healthy, functionally independent, cognitively intact volunteers aged ≥65 at low risk for serious fall injuries, assigned using permuted block randomization (age/gender) to intervention, active-control, or control group. The intervention is an 8-week program including individually tailored exercises for upper/lower body, flexibility, strength, and balance (dynamic, static, vestibular); active-controls receive exercising counselling according to WHO guidelines; controls receive no guidance. Primary outcome is participant fitness level, operationalized as 42 digital markers generated from 10 motor fitness measures (balance, strength, flexibility); measured at baseline, mid-trial (4-weeks), trial-end (8-weeks), and follow-up (12-weeks). Target sample size is 300 participants to provide 99% power for moderate and high effect sizes (Cohen's f = 0.25, 0.40 respectively). DISCUSSION: The study will help understand the value of individualized motor fitness assessment used to generate personalized multicomponent exercise programs, delivered remotely among older adults. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04181983.

Population aging and migration - history and UN forecasts in the EU-28 and its east and south near neighborhood - one century perspective 1950-2050.

BACKGROUND: There is a gap in knowledge on long term pace of population aging acceleration and related net-migration rate changes in WHO European Region and its adjacent MENA countries. We decided to compare European Union (EU-28) region with the EU Near Neighborhood Policy Region East and EU Near Neighborhood Policy Region South in terms of these two essential features of third demographic transition. One century long perspective dating back to both historical data and towards reliable future forecasts was observed. METHODS: United Nation's Department of Economic and Social Affairs estimates on indicators of population aging and migration were observed. Time horizon adopted was 1950-2050. Targeted 44 countries belong to either one of three regions named by EU diplomacy as: European Union or EU-28, EU Near Neighborhood Policy Region East (ENP East) and EU Near Neighborhood Policy Region South (ENP South). RESULTS: European Union region currently experiences most advanced stage of demographic aging. The latter one is the ENP East region dominated by Slavic nations whose fertility decline continues since the USSR Era back in late 1980s. ENP South region dominated by Arab League nations remains rather young compared to their northern counterparts. However, as the Third Demographic Transition is inevitably coming to these societies they remain the spring of youth and positive net emigration rate. Probably the most prominent change will be the extreme fall of total fertility rate (children per woman) in ENP South countries (dominantly Arab League) from 6.72 back in 1950 to medium-scenario forecasted 2.10 in 2050. In the same time net number of migrants in the EU28 (both sexes combined) will grow from - 91,000 in 1950 to + 394,000 in 2050. CONCLUSIONS: Long term migration from Eastern Europe westwards and from MENA region northwards is historically present for many decades dating back deep into the Cold War Era. Contemporary large-scale migrations outsourcing from Arab League nations towards rich European Protestant North is probably the peak of an iceberg in long migration routes history. However, in the decades to come acceleration of aging is likely to question sustainability of such movements of people.

Active and Healthy Lifestyle - Nationwide Programs in Israeli Schools.

The World Health Organization (WHO) announced the 'Global School Health Initiative' in 1995 following recommendations formulated in the Ottawa Charter for Health Promotion. Hence, the aims of the present study were to describe the various programs for nurturing an active and healthy lifestyle implemented during 2011-12 in schools in Israel, and to identify variables that may explain the success versus lack of success in implementing these programs. Participants were a nationwide representative sample of 126 school principals from six supervisory districts of the Ministry of Education, including six sectors, from the elementary, junior-high and senior-high school levels. Semi-structured telephone interviews were recorded and processed using the ATLAS.ti software for qualitative analysis. Physical education teachers, sciences teachers and social coordinators led the programs' implementation. The programs included four main activities domains: health, physical education, nutrition and sustainability. Three types of program implementation were observed: leading principles, teaching methods, and external programs. Parents were involved mostly in elementary schools. Evidence of program integration into school life was presented by changes in children's behaviors, whereas difficulties stemmed from lack of budget and teaching hours. Science and physical education lessons constituted the anchor for the programs. The schools needed a committed leader to help conduct and maintain the program. Thus, the role of the school principal was to initiate the idea of developing a program, encourage its implementation, select a leader for the program, and then, most importantly, to reinforce the teachers' enthusiasm.

Acute aerobic activity enhances response inhibition for less than 30min.

Acute exercise appears to facilitate certain aspects of cognitive processing. The possibility that exercise may lead to more efficient inhibitory processes is of particular interest, owing to the wide range of cognitive and motor functions that inhibition may underlie. The purpose of the present study was to examine the immediate and the delayed effect of acute aerobic exercise on response inhibition, motor planning, and eye-hand coordination in healthy active adults. Forty healthy and active participants (10 females) with a mean age of 51.88±8.46years performed the Go-NoGo test (response inhibition) and the Catch Game (motor planning and eye-hand coordination) before, immediately after, and following a 30-min recovery period in two conditions: a moderate-intensity aerobic session and a control session. In 2-way repeated measures ANOVAs (2 treatments×3 times) followed by contrast comparisons for post hoc analyses, significant pre-post interactions - indicating improvements immediately following exercise but not following the control condition - were observed in the Go-NoGo measures: Accuracy, Reaction Time, and Performance Index, but not in the Catch Game. In the post-follow-up interaction a deterioration was observed in Performance Index, and a trend of deterioration in Accuracy and Reaction Time. The conclusion was that a single session of moderate-intensity aerobic exercise facilitates response inhibition, but not motor planning or eye-hand coordination, in middle-aged healthy active adults. On the other hand, the improvement does not last 30min following a recovery period. Further studies are needed to examine the duration of the inhibitory control benefits and the accumulative effect of a series of acute exercise bouts, as well as to determine the brain networks and/or neurotransmitter systems most affected by the intervention.

Selecting an appropriate control group for studying the effects of exercise on cognitive performance.

Differences in expectations between experimental and control groups can influence the outcomes of exercise interventions, emphasizing the need to match expectations across study groups. This online study examined whether the expectations to improve the performance of different cognitive tasks differ between various activities commonly used in research on the effects of exercise and cognitive function. Two hundred and five middle-aged adults performed two reaction-time tasks and one memory task. They were then asked to rate, on a 1-5 Likert scale, their expectations to improve performance in those tasks should they engage in six types of activities for three months: brisk walking, resistance exercise, stretching and balance exercises, watching videos with lectures on art, history, and science, a program of relaxation techniques, and yoga/tai chi/meditation. Results revealed that the highest expectations for improvement were associated with relaxation techniques and yoga/tai chi/meditation. Some activities, such as brisk walking and stretch and balance exercises, shared similar expectations. Previous knowledge of the possible beneficial effects of exercise on cognitive performance also led to higher expectations. To establish causal relationships, researchers should strive to use activities that share similar expectations to improve performance for the experimental and control groups. The findings of this study provide such activity pairs. Finally, researchers should also try to match participants with and without prior knowledge of the benefits of exercise to cognitive function between experimental and control groups.

Chronic exercise effects on overall depression severity and distinct depressive symptoms in older adults: A protocol of a systematic and meta-analytic review.

INTRODUCTION: There is high evidence that chronic exercise benefits overall depression severity in older adults. However, late-life depression is characterized by considerable heterogeneity in clinical manifestation emphasizing the need for more individualized exercise intervention programs. Therefore, the objective of the proposed review is to investigate the effects of chronic exercise on overall depression severity and on different symptoms of depression in randomized controlled trials (RCTs) including older adults with a mean age of at least 60 years, and by considering the moderating effects of intervention characteristics and individual characteristics. METHODS: This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). We will use the Population-Intervention-Comparator-Outcomes-Study design (PICOS) criteria for study inclusion and will search the following database sources for relevant RCTs: Web of Science, Academic Search Complete, CINAHL, APA Psycinfo, SPORTDiscuss, Cochrane. Two independent reviewers will conduct the study selection, data extraction, and quality assessment. Disagreement will be solved by a third reviewer. Primary outcome will be changes in overall depression severity and secondary outcomes will encompass changes in symptoms of depression as defined by the DSM-5, such as sleep quality, fatigue, anxiety, mood, apathy, changes in weight, information processing speed, and executive functions, from baseline until the end of the intervention and to any available intermediary measurement or follow up. Meta-analysis will be undertaken to synthesize the effects of chronic exercise on primary and secondary outcomes. Subgroup analysis will investigate the moderating effects of intervention characteristics (frequency, intensity, duration, type of exercise, cognitive demand, social interactions, exercise supervision, behavioral change techniques, compliance, study design, dropout-rate, type of control group) and individual characteristics (age, sex, education, functional capacity, global cognition, population) on primary and secondary outcomes. Additionally, we plan to assess quality of evidence and publication bias, and to carry out sensitivity analysis. CONCLUSION: The results of the proposed review are anticipated to have a substantial impact on research and clinical practice. On the one hand, the review's conclusions could form the foundation for developing evidence-based recommendations for individualized exercise programs that alleviate depression in older adults. On the other hand, by revealing research gaps, the review results could encourage the formulation of research questions for further RCTs. PROTOCOL REGISTRATION NUMBER: This protocol has been published in the Prospero repository (PROSPERO 2022 CRD42022361418, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022361418).

Effects of chronic physical exercise on executive functions and episodic memory in clinical and healthy older adult populations: a systematic review and meta-analysis protocol.

BACKGROUND: Executive functions (EFs) and episodic memory are fundamental components of cognition that deteriorate with age and are crucial for independent living. While numerous reviews have explored the effect of exercise on these components in old age, these reviews screened and analyzed selected older adult populations, or specific exercise modes, thus providing only limited answers to the fundamental question on the effect of exercise on cognition in old age. This article describes the protocol for a systematic review and multilevel meta-analytic study aiming at evaluating the effectiveness of different types of chronic exercise in improving and/or maintaining EFs and long-term episodic memory in older adults. METHODS AND ANALYSIS: The study protocol was written in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Several databases will be searched. Randomized controlled trials (RCTs) conducted in older adults aged ≥ 60 years providing any kind of planned, structured, and repetitive exercise interventions, and EFs and/or episodic memory measures as outcomes, published in English in peer-reviewed journals and doctoral dissertations will be included. Two independent reviewers will screen the selected articles, while a third reviewer will resolve possible conflicts. The Cochrane risk-of-bias tool will be used to assess the quality of the studies. Finally, data will be extracted from the selected articles, and the formal method of combining individual data from the selected studies will be applied using a random effect multilevel meta-analysis. The data analysis will be conducted with the metafor package in R. DISCUSSION AND CONCLUSION: This review will synthesize the existing evidence and pinpoint gaps existing in the literature on the effects of exercise on EFs and episodic memory in healthy and unhealthy older adults. Findings from this meta-analysis will help to design effective exercise interventions for older adults to improve and/or maintain EFs and episodic memory. Its results will be useful for many researchers and professionals working with older adults and their families. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022367111.

Loneliness is associated with an increased risk of sedentary life in older Israelis.

OBJECTIVES: Both loneliness and insufficient physical activity are common in old age. This study investigated the association between loneliness and adherence to recommended guidelines of physical activity in a national sample of Israelis, and examined whether loneliness was a risk factor for insufficient physical activity independent of other variables. METHODS: A random sample of 1663 (799 men) older adults aged 65+ reported their physical activity routine, and based on official guidelines were categorized as sufficiently active, insufficiently active, and inactive. In addition, they were divided into lonely or not lonely based on a single question from the Center for Epidemiologic Studies Depression Scale. RESULTS: Chi-square analyses indicated that loneliness, but not living alone, were inversely related to level of physical activity in both genders. Based on multinomial stepwise logistic regressions body mass index, being religious versus secular, self-rated health, and education were associated with engaging in physical activity in men (Cox & Snell R(2) = 0.202). Loneliness contributed significantly to explaining the level of participation in physical activity beyond these variables in women, but not in men (Cox & Snell R(2) = 0.197). CONCLUSIONS: Loneliness is associated with an increasing risk of inactivity in advanced age in women. Further research inquiring into whether loneliness is the cause of reduced physical activity or whether physical activity acts as a protective factor against loneliness is needed. Developing and implementing tailored intervention programs that encourage social interaction in combination with a physical activity program are recommended.

The effect of acute exercise on cognitive and motor inhibition - Does fitness moderate this effect?

BACKGROUND: Given the extensive evidence on improvements in cognitive inhibition immediately following exercise, and the literature indicating that cognitive and motor inhibitory functions are mediated by overlapping brain networks, the aim of this study was to assess, for the first time, the effect of moderate intensity acute aerobic exercise on multi-limb motor inhibition, as compared to cognitive inhibition. METHOD: Participants were 36 healthy adults aged 40-60 years old (mean age 46.8 ± 5.7), who were randomly assigned to experimental or control groups. One-to-two weeks following baseline assessment, participants were asked to perform a three-limb (3-Limb) inhibition task and a vocal version of the Stroop before and after either acute moderate-intense aerobic exercise (experimental group) or rest (control). RESULTS: Similar rates of improvement were observed among both groups from baseline to the pre-test. Conversely, a meaningful, yet non-significant trend was seen among the experimental group in their pretest to posttest improvement in both cognitive and motor tasks. In addition, exploratory analysis revealed significant group differences in favor of the experimental group among highly fit participants on the 3-Limb task. A significant correlation was indicated between the inhibition conditions, i.e., choice in the motor inhibition and color/word (incongruent) in the cognitive inhibition, especially in the improvement observed following the exercise. DISCUSSION: Moderate-intensity acute aerobic exercise is a potential stimulator of both multi-limb motor inhibition and cognitive inhibition. It appears that high-fit participants benefit from exercise more than low-fit people. Additionally, performance on behavioral tasks that represent motor and cognitive inhibition is related. This observation suggests that fitness levels and acute exercise contribute to the coupling between cognitive and motor inhibition. Neuroimaging methods would allow examining brain-behavior associations of exercise-induced changes in the brain.

Evidence-based yet still challenging! Research on physical activity in old age.

Preserving functional health and quality-of-life in old age is a major goal and global challenge in public health. The high rate of sedentary behavior that is characteristic of the older adult population exacerbates impairments of physiological and structural systems that are typically seen in the aging process. Achieving an understanding of the profound influence of physical activity on all aspects of health in old age is the driving force behind the emergence of "physical activity in old age" as a growing area of research. Accumulated evidence implies that being physically active and exercising is far superior to other optimal aging facilitators. Yet this area of research faces numerous constraints and obstacles. This commentary addresses some of these challenges, primarily the heterogeneity of the aging process, which induces both inter- and intra-individual differences among aged individuals, heterogeneity in assessment tools, unjustified inclusion/exclusion criteria and insufficient recruitment strategies, difficulties in implementing research results in real-world conditions, and rudimentary exploitation of innovative technology. We explain the importance of establishing a network of multidisciplinary scientists and stakeholders to propose consensus-based goals and scientifically evidenced wide-ranging plans for dealing with these challenges. In addition, we suggest work directions for this network.

Myokines as mediators of exercise-induced cognitive changes in older adults: protocol for a comprehensive living systematic review and meta-analysis.

Background: The world's population is aging, but life expectancy has risen more than healthy life expectancy (HALE). With respect to brain and cognition, the prevalence of neurodegenerative disorders increases with age, affecting health and quality of life, and imposing significant healthcare costs. Although the effects of physical exercise on cognition in advanced age have been widely explored, in-depth fundamental knowledge of the underlying mechanisms of the exercise-induced cognitive improvements is lacking. Recent research suggests that myokines, factors released into the blood circulation by contracting skeletal muscle, may play a role in mediating the beneficial effect of exercise on cognition. Our goal in this ongoing (living) review is to continuously map the rapidly accumulating knowledge on pathways between acute or chronic exercise-induced myokines and cognitive domains enhanced by exercise. Method: Randomized controlled studies will be systematically collected at baseline and every 6 months for at least 5 years. Literature search will be performed online in PubMed, EMBASE, PsycINFO, Web of Science, SportDiscus, LILACS, IBECS, CINAHL, SCOPUS, ICTRP, and ClinicalTrials.gov. Risk of bias will be assessed using the Revised Cochrane Risk of Bias tool (ROB 2). A random effects meta-analysis with mediation analysis using meta-analytic structural equation modeling (MASEM) will be performed. The primary research question is to what extent exercise-induced myokines serve as mediators of cognitive function. Secondarily, the pooled effect size of specific exercise characteristics (e.g., mode of exercise) or specific older adults' populations (e.g., cognitively impaired) on the relationship between exercise, myokines, and cognition will be assessed. The review protocol was registered in PROSPERO (CRD42023416996). Discussion: Understanding the triad relationship between exercise, myokines and cognition will expand the knowledge on multiple integrated network systems communicating between skeletal muscles and other organs such as the brain, thus mediating the beneficial effects of exercise on health and performance. It may also have practical implications, e.g., if a certain myokine is found to be a mediator between exercise and cognition, the optimal exercise characteristics for inducing this myokine can be prescribed. The living review is expected to improve our state of knowledge and refine exercise regimes for enhancing cognitive functioning in diverse older adults' populations. Registration: Systematic review and meta-analysis protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on the 24th of April 2023 (registration number CRD42023416996).

Psychological functioning and adherence to the recommended dose of physical activity in later life: results from a national health survey.

BACKGROUND: Official health organizations have established the dose of physical activity needed for preserving both physical and psychological health in old age. The objective of this study was to explore whether adherence to the recommended criterion of physical activity accounted for better psychological functioning in older adults in Israel. METHODS: A random sample of 1,663 (799 men) Israelis reported their physical activity routine, and based on official guidelines were divided into sufficiently active, insufficiently active, and inactive groups. The General Health Questionnaire (GHQ) was used for assessing mental health and the Mini-Mental State Examination (MMSE) for assessing cognitive functioning. RESULTS: Factor analysis performed on the GHQ yielded two factors - positive and negative. Logistic regressions for the GHQ factors and for the MMSE were conducted for explaining their variance, with demographic variables entered first, followed by health and then physical activity. The explained variance in the three steps was Cox and Snell R2 = 0.022, 0.023, 0.039 for the positive factor, 0.066, 0.093, 0.101 for the negative factor, and 0.204, 0.206, 0.209 for the MMSE. CONCLUSIONS: Adherence to the recommended dose of physical activity accounted for better psychological functioning beyond demographic and health variables; however, the additional explained variance was small. More specific guidelines of physical activity may elucidate a stronger relationship, but only randomized controlled trials can reveal cause-effect relationship between physical activity and psychological functioning. More studies are needed focusing on the positive factor of psychological functioning.

Prediction of standing height among Israeli older adults: results from a national survey.

BACKGROUND: An accurate measurement of full height while standing is sometimes not possible among older adults, in particular among the frail elderly. For such cases, the use of knee height (KH) and ulna bone length (UL) has been suggested for standing height estimation. Studies have shown that predictive equations of height were ethnic-specific. AIM: This study attempted to develop representative equations to predict standing height based on KH, UL and waist circumference (WC) for older adult Israeli women and men. SUBJECTS AND METHODS: A random sample of 1500 older adults (aged 74.48 ± 6.09 years old). Participants were interviewed in their homes and measurements of Standing height, KH, UL and WC were taken. A quadratic regression analysis, for each sex separately, was performed to predict standing height based on age, KH, UL and WC. RESULTS: The adjusted r (2) standing height prediction equations were 0.51 and 0.67 for women and men, respectively. CONCLUSIONS: The prediction of the standing height of frail elderly Israelis, by KH, UL, WC and age, may be an alternative method when actual standing height is difficult or not possible to measure.

Effect of physical activity interventions on quality of life in older adults: A protocol for systematic review and meta-analysis.

INTRODUCTION: Quality of life (QoL) has been acknowledged as a fundamental concept in the field of health and is favorably improved by physical activity (PA). This systematic review aims to assess the benefits and harms of different types of PA to improve health-related QoL in both community-dwelling and diseased older adults to provide a recommendation for the minimum amount of PA needed to obtain measurable QoL benefits. METHODS AND ANALYSIS: We will search MEDLINE, Cochrane Central Register of Controlled Trials, CINHAL, Epistemonikos, Web of Science and gray literature. Randomized controlled trials enrolling healthy or diseased older adults aged > 65 years, providing any kind of physical activity intervention and having quality of life as an outcome will be included. There will be no language restriction. Two independent reviewers will screen the papers, and a third reviewer will resolve the conflicts. The quality of the included studies will be assessed through the Risk of Bias 2.0 tool. Finally, data will be extracted to create proper meta-analyses of comparisons between the different kinds of physical activity interventions or to control groups. ETHICS AND DISSEMINATION: This review does not require approval from the Ethics Committee. The results will be disseminated in peer-reviewed journals and at international conferences; moreover, the findings will be shared on social media using an accessible language.

Aerobic fitness and multidomain cognitive function in advanced age.

BACKGROUND: Studies generally describe the relationship between physical fitness and cognitive function by measuring only one or two specific cognitive tasks. In addition, in spite of the significant increase in life expectancy, the age of participants in these studies does not extend beyond a mean age of 70 years. This study was thus designed to examine the relationship between physical fitness and function in multiple cognitive domains in subjects older than those previously reported. METHODS: Thirty-eight individuals, aged 65.3 to 85.3 years, performed a graded, progressive, maximal exercise test. Based on a median score of peak VO2, participants were divided into low-fitness and moderately-fit groups. Cognitive function was assessed by means of a computerized neuropsychological battery. RESULTS: The moderately-fit group achieved significantly better scores on the global cognitive score (U = 97, p = 0.04), and a significant correlation was found between peak VO2 and attention, executive function, and global cognitive score (rs = .37, .39, .38 respectively). The trend for superior cognitive scores in the moderate-fitness compared to the low-fitness groups was unequivocal, both in terms of accuracy and reaction time. CONCLUSION: Maintenance of higher levels of cardiovascular fitness may help protect against cognitive deterioration, even at an advanced age. An adequately powered randomized controlled trial should be performed to further evaluate this hypothesis.

Arm-curl field test for older women: is it a measure of arm strength?

The facilitative effect of physical activity on age-related decline is well documented. Specifically, it has been found to reduce the risk of dependency. However, physical activity programs for older adults should be carefully designed so that improvements in all aspects of movement and physical capacities are achieved. This means that efficient fitness measurements should be made available for coaches and trainers. The arm-curl test is a common field test known for measuring the strength of upper extremities in older age. The objective of the current study was to determine to what extent this test indeed assesses arm strength as well as other fitness aspects such as arm muscle endurance or general endurance. Scores of the arm-curl test were compared with strength and endurance of elbow flexors measured by an isokinetic dynamometer and general endurance measured by a stress test in 48 independently functioning women (age 72.04 ± 6.28 yr). Significant correlations were indicated between the arm-curl scores and both isokinetic endurance (r = 0.452) and general endurance (r = 0.437); however, a very low nonsignificant correlation was found between the arm-curl and isokinetic maximal strength scores. Coaches must be aware of the fact that the repetitive arm-curl exercise contains a significant aerobic component and thus may contribute to aerobic fitness and arm muscle endurance but not necessarily to arm strength.

Behavioral and Neurophysiological Aspects of Inhibition-The Effects of Acute Cardiovascular Exercise.

This review summarizes behavioral and neurophysiological aspects of inhibitory control affected by a single bout of cardiovascular exercise. The review also examines the effect of a single bout of cardiovascular exercise on these processes in young adults with a focus on the functioning of prefrontal pathways (including the left dorsolateral prefrontal cortex (DLPFC) and elements of the prefrontal-basal ganglia pathways). Finally, the review offers an overview on the potential effects of cardiovascular exercise on GABA-ergic and glutamatergic neurotransmission in the adult brain and propose mechanisms or processes that may mediate these effects. The main findings show that a single bout of cardiovascular exercise can enhance inhibitory control. In addition, acute exercise appears to facilitate activation of prefrontal brain regions that regulate excitatory and inhibitory pathways (specifically but not exclusively the prefrontal-basal-ganglia pathways) which appear to be impaired in older age. Based on the reviewed studies, we suggest that future work examine the beneficial effects of exercise on the inhibitory networks in the aging brain.