Reversal of cognitive impairment in a hypotensive elderly population using a passive exercise intervention (original) (raw)
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Postural Hypotension and Cognitive Function in Older Adults
Gerontology and Geriatric Medicine
Background: Cognitive decline in the elderly is associated with chronic cerebral hypoperfusion. While many forms of exercise can slow or reverse cognitive decline, compliance in unsupervised exercise programs is poor. Objective: We address whether passive exercise, that is, muscle stimulation, is capable of reversing postural hypotension in an older adult population sufficiently to significantly improve cognitive function as measured by executive function tests. Subjects and Methods: In this study, 50- to 80-year-old women underwent cognitive testing, long-duration cardiac hemodynamic recordings during quiet sitting, and 60 min of soleus muscle stimulation with continued hemodynamic recording. Results: Two thirds of our subjects were hypotensive (diastolic blood pressure [DBP] < 70 mmHg) after 30 min of quiet sitting. Cognitive performance was significantly better in individuals with higher DBPs (0.79 s per 1-mmHg increase in DBP). Soleus muscle stimulation resulted in an average...
Frontiers in Aging Neuroscience, 2021
Background: The impact of exercise on cognition in older adults with hypertension and subjective cognitive decline (SCD) is unclear. Objectives: We determined the influence of high-intensity interval training (HIIT) combined with mind-motor training on cognition and systolic blood pressure (BP) in older adults with hypertension and SCD. Methods: We randomized 128 community-dwelling older adults [age mean (SD): 71.1 (6.7), 47.7% females] with history of hypertension and SCD to either HIIT or a moderate-intensity continuous training (MCT) group. Both groups received 15 min of mind-motor training followed by 45 min of either HIIT or MCT. Participants exercised in total 60 min/day, 3 days/week for 6 months. We assessed changes in global cognitive functioning (GCF), Trail-Making Test (TMT), systolic and diastolic BP, and cardiorespiratory fitness. Results: Participants in both groups improved diastolic BP [F(1, 87.32) = 4.392, p = 0.039], with greatest effect within the HIIT group [estim...
BMC Neurology, 2010
Background: Sub-cortical vascular ischaemia is the second most common etiology contributing to cognitive impairment in older adults, and is frequently under-diagnosed and under-treated. Although evidence is mounting that exercise has benefits for cognitive function among seniors, very few randomized controlled trials of exercise have been conducted in populations at high-risk for progression to dementia. Aerobic-based exercise training may be of specific benefit in delaying the progression of cognitive decline among seniors with vascular cognitive impairment by reducing key vascular risk factors associated with metabolic syndrome. Thus, we aim to carry out a proof-of-concept single-blinded randomized controlled trial primarily designed to provide preliminary evidence of efficacy aerobic-based exercise training program on cognitive and everyday function among older adults with mild sub-cortical ischaemic vascular cognitive impairment.
Artery Research
Systemic Arterial Hypertension (SAH) is a chronic condition that requires clinical treatment and is associated with increased risk of cognitive impairment and dementia. Therefore, strategies with fewer side effects and less invasive procedures are required. Evidence supports that Physical Exercise (PE) has antihypertensive effects and has proven to be an efficient and complementary tool for managing hypertension, reducing cardiovascular disease risk factors, and improving cerebral perfusion in the majority of healthy populations. Much of this cardiovascular-protective effect of PE is probably due to pluripotent effects on the vasculature, including regulation of vascular tone, energy metabolism, microvascular recruitment, and endothelial function (reducing oxidative stress and preserving NO availability). These factors are speculated to work synergistically, thereby reducing systolic and diastolic blood pressure and are directly related to improved cerebrovascular function. However, few studies have specifically examined the potential positive effects of PE on the brain in hypertensive individuals. In this brief review, we discuss the potential effect of different PE modalities (aerobic, resistance, and combined) that may act as an effective preventive or therapeutic strategy for reducing blood pressure in hypertensives and, consequently, mitigate the association between hypertension, cognitive impairment and risk of dementia.
Low-Load Resistance Exercise Improves Cognitive Function in Older Adults
Revista Brasileira de Medicina do Esporte
Introduction: Resistance exercise (RE) training is widely recommended for increasing muscle strength and mass in older adults. RE is also a potential stimulus to improve cognitive functions (CF), but the best protocol for this purpose is unknown. Objective: To compare the effects of different RE protocols on CF in the same group of individuals. Methods: Twenty-four older adults were randomized (cross over) to control (CON) and lower limb RE protocols with high load (HL - 80% of 1RM), low load (LL - 30% of 1RM) and LL with blood flow restriction (LL-BFR - 30% of 1RM and 50% BFR). For CF assessment, participants underwent the Stroop test before and after each RE protocol. Results: Reduction in response time for Stroop neutral stimuli was greater after LL (effect size (ES) = -0.92) compared to CON (ES = -0.18) and HL (ES = -0.03), but was not different from LL-BFR (ES = -0.24). The reduced response time was associated with reduced parasympathetic modulation and increased cardiac output...
The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry, 2017
Systemic arterial hypertension (SAH) and diabetes mellitus (DM) are important risk factors for developing cognitive impairment. General life-style changes including physical training are known to reduce elevated blood pressure and sugar levels, as well as improve mental health. The objective of this study was to evaluate whether supervised physical exercise enhances the cognitive status of patients with chronic diseases. Volunteers with SAH, DM or SAH + DM participated in either aerobic or resistance training during a period of 12 weeks. Several domains of cognitive functions were evaluated using the mental test and training system before and after the 3 months. Participants with either of these chronic diseases demonstrated significantly improved attention and concentration, but not reaction time, following the supervised exercise. Structured physical training promotes several aspects of cognitive functions in diabetic and hypertensive patients.
2019
The purpose of this study is to investigate the effects of different types of acute exercise on cognitive function and cerebral oxygenation. A within-subject design was adopted. In total, 20 healthy older adults were enrolled in the study. They came to the laboratory individually on four separate days and completed four conditions of activity. Four conditions were sedentary reading control (RC), cognitive exercise (CE), physical exercise (PE) and cognitive+physical exercise (CE + PE). During these visits, participants completed the Stroop task before and immediately after the experimental condition, which consisted of 15 min of aerobic exercise, verbal fluency task (VFT), and dual task. The Stroop task included the following two conditions: a naming condition and an executive condition. The fNIRS is an optical method using near-infrared light to measure relative changes of oxygenated (O2Hb) and deoxygenated (HHb) hemoglobin in the cortex. The results indicate that acute exercise facilitates performance for executive tasks, not only combined cognition, but also the different results between combined exercise and single exercise. The fNIRS findings showed that acute single exercise influences oxygenation for executive tasks but not for naming tasks. Greater improvement was observed in the post-exercise session of combined exercise during the modified Stroop. These findings demonstrate that acute single exercise, single cognition exercise, and combined exercise enhanced the performance of the inhibition control task. Only acute combined exercise has a general facilitative effect on inhibition control. Combined exercise was shown to be superior to single exercise for task-efficient cerebral oxygenation and improved oxygen utilization during cortical activation in older individuals. Also, to maximize the performance of cognition it may be important for older adults to take part in more cognitive demand exercise or take more kinds of exercise.
BMC Geriatrics, 2013
Background: Aging and physical inactivity are associated with declines in some cognitive domains and cerebrovascular function, as well as an elevated risk of cerebrovascular disease and other morbidities. With the increase in the number of sedentary older Canadians, promoting healthy brain aging is becoming an increasingly important population health issue. Emerging research suggests that higher levels of physical fitness at any age are associated with better cognitive functioning and this may be mediated, at least in part, by improvements in cerebrovascular reserve. We are currently conducting a study to determine: if a structured 6-month aerobic exercise program is associated with improvements or maintenance of both cerebrovascular function and cognitive abilities in older individuals; and, the extent to which any changes seen persist 6 months after the completion of the structured exercise program.
Alzheimer's disease (AD) is the most common form of dementia diagnosed amongst the elderly. Mild cognitive impairment (MCI) is a condition often indicative of the earliest symptomatology of AD with 10%–15% of MCI patients reportedly progressing to a diagnosis of AD. Individuals with a history of vascular risk factors (VRF's) are considered high risk candidates for developing cognitive impairment in later life. Evidence suggests that vascular injury resulting from untreated VRF's promotes progression from MCI to AD and exacerbates the severity of dementia in AD, and neuroimaging studies have found that the neurodegenerative processes associated with AD are heavily driven by VRF's that promote cerebral hypoperfusion. Subsequently, common links between vascular disorders such as hypertension and neurodegenerative disorders such as AD include compromised vasculature, cerebral hypoperfusion and chronic low grade inflammation (a hallmark of both hypertension and AD). Exercise has been demonstrated to be an effective intervention for blood pressure management, chronic low grade inflammation and improvements in cognition. Data from recent analyses suggests that isometric exercise training (IET) may improve vascular integrity and elicit blood pressure reductions in hypertensives greater than those seen with dynamic aerobic and resistance exercise. IET may also play an effective role in the management of VRF's at the MCI stage of AD and may prove to be a significant strategy in the prevention, attenuation or delay of progression to AD. A plausible hypothesis is that the reactive hyperemia stimulated by IET initiates a cascade of vascular, neurotrophic and neuro-endocrine events that lead to improvements in cognitive function.
The Effectiveness of Exercise on Improving Cognitive Function in Older People
Journal of Nursing Research, 2011
This population is expected to continue to grow through the next 30 years. Thus, aging is an increasingly important focus of Taiwan public health. Aging affects the functioning of central nervous, skeletomuscular, cardiopulmonary, and other organ systems. Particularly, as a person ages, brain weight decreases 10% to 20%, blood flow slows by 30%Y40%, and the cranial nerve filament becomes entwined and develops plaque. These changes culminate in memory loss, reduced learning ability, and degradation of cognitive function, all of which undermine the independence of older people in their activities of daily living and generate stress on the family, society, the healthcare system, and the economy (Pang et al., 2002). As a population ages, the need for effective methods to slow the decline of cognitive function and even improve older adults' cognitive performance to maintain their independent function has become increasingly urgent. As such, the well-documented physical benefits of exercise and the value of exercise for improving mental health have grown in importance (Hoffman et al., 2008). In the last decade, the use of exercise to slow cognitive decline and maintain the fluid intelligence of older people has greatly increased. Several mechanisms have been suggested to explain the relationship between exercise and cognitive functioning. First, the main hypothesis is that exercise directly affects brain structure and functions. Increases in aerobic capacity are thought to augment cerebral blood flow, improve the utilization of oxygen and glucose in the brain, accelerate the transport of biochemical waste substances to maintain a stable flow of blood, and enhance blood antioxidant enzyme (glutathione peroxidase, GSH-Px) activity to clear oxidative free radicals rapidly away (Radak et al., 2001). Second, exercise can promote the synthesis of neurogrowth factors such