Neuropsychological and neurophysiological effects of strengthening exercise for early dementia: a pilot study

Research demonstrates a positive effect of aerobic exercise on cognitive functioning in older adults. Unfortunately, aerobic exercise is often contraindicated for older adults due to cardiovascular and functional limitations. Low-intensity strengthening exercise may offer a practical alternative, but the neuropsychological benefits and potential neurophysiological mechanisms are less well understood. The current study evaluated the effects of a 10-week strengthening exercise intervention on cognitive functioning and EEG in a sample of 13 older adults with early dementia, and 9 normative controls. Results revealed beneficial effects of strengthening exercise on verbal memory coupled with frontal beta and delta power asymmetries and N200 amplitude asymmetry. Results point to increased cognitive efficiency following 10 weeks of strengthening exercise. The findings suggest it is feasible to conduct a strengthening intervention with early dementia patients, and to gather neuropsychological and neurophysiological data to evaluate outcomes. Strengthening exercise may serve as a useful alternative to aerobic exercise.     

Strategy-Based Cognitive Training for Improving Executive Functions in Older Adults: a Systematic Review

Given projected increases in dementia prevalence, emphasising earlier stages of cognitive impairment in older adults enables targeted early intervention strategies. Strategy-based cognitive training (SCT) is a remedial approach involving guidance and practice in compensatory techniques to improve cognition, including memory and attention. It may also be effective for improving executive functions (EF) integral to everyday tasks. This review systematically evaluates SCT effects on EF in older adults without dementia. Following PRISMA guidelines, we reviewed eligible trials according to pre-defined criteria, differentiating SCT from other cognitive interventions and stipulating total EF-focused intervention time, study design and target population (healthy older adults or mild cognitive decline). We then evaluated trials according to design, methodological quality and outcomes. Unfortunately, with too few studies in mild cognitive impairment, we refocused our review only on healthy older adults. Thirteen studies with 4120 participants in total were included, primarily targeting inductive reasoning. Despite heterogeneous study designs and SCT programs, 11/13 trials reported significant EF improvements, generally of moderate effect size (Hedges’ g > 0.3). Four studies reported sustained benefits from one month to 10 years. There was some evidence of far transfer. We conclude that there is promising evidence for SCT as a targeted intervention for EF in healthy older adults and preliminary evidence for maintaining effects over time. Fewer trials have investigated far transfer (e.g. improved everyday functioning) or capacity to delay/prevent dementia, which are most relevant to clinical utility. Limitations include the inability to calculate effect sizes for four studies and absence of statistical meta-analysis.     

Improving aerobic capacity in healthy older adults does not necessarily lead to improved cognitive performance

The effects of aerobic exercise training in a sample of 85 older adults were investigated. Ss were assigned randomly to either an aerobic exercise group, a nonaerobic exercise (yoga) group, or a waiting-list control group. Following 16 weeks of the group-specific protocol, all of the older Ss received 16 weeks of aerobic exercise training. The older adults demonstrated a significant increase in aerobic capacity (cardiorespiratory fitness). Performance on reaction-time tests of attention and memory retrieval was slower for the older adults than for a comparison group of 24 young adults, and there was no improvement in the older adults' performance on these tests as a function of aerobic exercise training. Results suggest that exercise-related changes in older adults' cognitive performance are due either to extended periods of training or to cohort differences between physically active and sedentary individuals.     

Time of Day Affects Episodic Memory in Older Adults*

ABSTRACT

The neuropsychological test scores of 2,030 cognitively normal older adults were examined to evaluate performance patterns as they related to time of day (TOD) at which testing was initiated. Multiple regression analyses were used to examine the association of TOD with scores on seven neuropsychological tests used in the clinical evaluation of dementia. Episodic memory performance was significantly related to TOD, while memory span and verbal fluency were not. Best performance occurred during early morning hours and late afternoon; worst performance occurred mid-day (i.e., noon). These findings may have implications for clinical assessment, the design of research on dementia, and the daily functioning of older adults.     

Self-Reported Cognitive Inconsistency in Older Adults

ABSTRACT

Insight into one's own cognitive abilities, or metacognition, has been widely studied in developmental psychology. Relevance to the clinician is high, as memory complaints in older adults show an association with impending dementia, even after controlling for likely confounds. Another candidate marker of impending dementia under study is inconsistency in cognitive performance over short time intervals. Although there has been a recent proliferation of studies of cognitive inconsistency in older adults, to date, no one has examined adults' self-perceptions of cognitive inconsistency. Ninety-four community-dwelling older adults (aged 70–91) were randomly selected from a parent longitudinal study of short-term inconsistency and long-term cognitive change in aging. Participants completed a novel 40-item self-report measure of everyday cognitive inconsistency, including parallel scales indexing perceived inconsistency 5 years ago and at present, yielding measures of past, present, and 5-year change in inconsistency. The questionnaire showed acceptable psychometric characteristics. The sample reported an increase in perceived inconsistency over time. Higher reported present inconsistency and greater 5-year increase in inconsistency were associated with noncognitive (e.g., older age, poorer ADLs, poorer health, higher depression), metacognitive (e.g., poorer self-rated memory) and neuropsychological (e.g., poorer performance and greater 5-year decline in global cognitive status, vocabulary, and memory) measures. Correlations between self-reported inconsistency and neuropsychological performance were attenuated, but largely persisted when self-rated memory and age were controlled. Observed relationships between self-reported inconsistency and measures of neuropsychological (including memory) status and decline suggest that self-perceived inconsistency may be an area of relevance in evaluating older adults for memory disorders.     

Time of day affects episodic memory in older adults

The neuropsychological test scores of 2030 cognitively normal older adults were examined to evaluate performance patterns as they related to time of day (TOD) at which testing was initiated. Multiple regression analyses were used to examine the association of TOD with scores on seven neuropsychological tests used in the clinical evaluation of dementia. Episodic memory performance was significantly related to TOD, while memory span and verbal fluency were not. Best performance occurred during early morning hours and late afternoon; worst performance occurred mid-day (i.e., noon). These findings may have implications for clinical assessment, the design of research on dementia, and the daily functioning of older adults.     

运动习惯与社区老年人认知功能的关系

为评估社区老年人运动习惯与认知功能的关系,在北京市通过分层、方便取样的方法选取60岁以上的老年人732名,采用自编调查表收集一般人口学资料及运动习惯情况（包括有无运动习惯,运动频率,运动持续时间）,使用简明精神状态评估量表（MMSE）和北京版蒙特利尔认知评估量表（MoCA-BJ）评估认知功能。结果发现：（1）运动组整体认知功能及视空间定向能力得分均高于无运动组;（2）有无运动习惯可正向预测整体认知功能及视空间定向能力得分;（3）运动持续10年及以上组整体认知功能得分高于运动持续10年以下组。结果表明：相对于无运动习惯的社区老年人,有运动习惯的社区老年人的整体认知功能及视空间定向能力更好;运动持续年数较长,对社区老年人的认知功能起到促进作用。     

Protective effect of aerobic fitness on the detrimental influence of exhaustive exercise on information processing capacity

Although aerobic fitness has been thought to protect against the detrimental cognitive effects following exhaustive exercise, available evidence from studies using traditional mean behavioral measures remain somewhat equivocal.PurposeThis study aimed to reconcile this discrepancy by using a novel theory-driven diagnostic tool, the Systems Factorial Technology (SFT).MethodsSixty-six healthy young adults aged from 18 to 30 years old with different levels of aerobic fitness (n = 33 for the higher-fit and lower-fit groups) completed a go/nogo version of redundant-target task before and after a graded exercise test (GXT) until exhaustion. SFT was used to calculate the resilience capacity, which reflects the information processing capacity underlying inhibitory control.ResultsFollowing the GXT, both higher-fit and lower-fit groups showed faster responses while leaving accuracy unchanged as compared to the performance at the pretest. On the other hand, the resilience capacity decreased for the lower-fit group but was maintained for the higher-fit group.ConclusionThe present findings suggest that aerobic fitness may modulate the individual difference in decisional mechanism following exhaustive exercise. In sum, this study offers an alternative mechanistic explanation regarding cognitive individual differences in response to exhaustive exercise and provides novel insights into the significance of maintaining a state of high physical fitness for those who need to perform cognitively challenging tasks under physically stressful conditions (e.g., elite athletes).     

Aging, exercise, and attention.

The authors investigated the relationship among aging, attentional processes, and exercise in 2 experiments. First they examined age differences on 2 attentional tasks, a time-sharing task and an attentional flexibility task. Young adults alternated attention between 2 sequenced tasks more rapidly and time-shared the processing of 2 tasks more efficiently than older adults. They then investigated the effects of aerobic exercise on the same 2 attentional tasks in older adults. Following the 10-week exercise program, older exercisers showed substantially more improvement in alternation speed and time-sharing efficiency than older controls. Interestingly, this exercise effect was specific to dual-task processing. Both groups of subjects showed equivalent effects on single-task performance. These results indicate that aerobic exercise can exert a beneficial influence on the efficiency of at least 2 different attentional processes in older adults.     

Objective aerobic fitness level and neuropsychological functioning in healthy adolescents and emerging adults: Unique sex effects

ObjectiveResearch suggests positive relationships between aerobic fitness and cognition in older adults; however, limited research has adequately investigated the relationship between objectively measured aerobic fitness and broad cognitive functioning in healthy adolescents and young adults without psychiatric or physical health disorders. Further, studies to date have disproportionately examined males and failed to examine sex differences. Here we examine the relationship between aerobic fitness and neuropsychological functioning in physically healthy youth and whether sex moderates these findings.DesignSixty-four healthy emerging adults (16-25 years-old; 32 female) underwent measurement of objective aerobic fitness (VO₂ max) and neuropsychological assessment. Exclusion criteria included: left-handedness, prenatal medical issues or alcohol/illicit drug exposure, Axis-I psychiatric disorders, major medical disorders including metabolic conditions such as diabetes, hypertension, hyperlipidemia, major neurologic disorders, LOS greater than 2 min, intellectual disability or learning disability, regular substance use (e.g., greater than bi-weekly use of cannabis) or positive drug toxicology testing.MethodMultiple regressions examined VO₂ max, sex, sex*VO₂interaction in relation to neurocognition, controlling for objectively measured body fat percentage.ResultsPrior to including body fat percentage, higher VO₂ max related to improved working memory (Letter-Number Sequencing; p = .03) and selective attention (CPT-II hit response time standard error; p = .03). Aerobic fitness significantly interacted with sex, as higher-fit males had better performance on two sustained attention tasks while females did not demonstrate this pattern (CPT-II variability standard error, p = .047; Ruff 2&7 Total Speed, p = .02). Body fat percentage was positively slower cognitive flexibility (D-KEFS color-word switching/inhibition, p = .046).ConclusionsVO₂ independently predicted better working memory and selective attention. Increased aerobic fitness level related to increased performance on sustained attention tasks in males but not females. Therefore, aerobic fitness may be positively related to better cognitive functioning in physically healthy adolescents and emerging adults without metabolic conditions. Further research into factors (e.g., intensity or type of activity) that may relate to beneficial outcomes by sex are needed.     

Working memory training improvements and gains in non-trained cognitive tasks in young and older adults

Previous studies on working memory training have indicated that transfer to non-trained tasks of other cognitive domains may be possible. The aim of this study is to compare working memory training and transfer effects between younger and older adults (n = 60). A novel approach to adaptive n-back training (12 sessions) was implemented by varying the working memory load and the presentation speed. All participants completed a neuropsychological battery of tests before and after the training. On average, younger training participants achieved difficulty level 12 after training, while older training participants only reached difficulty level 5. In younger participants, transfer to Verbal Fluency and Digit Symbol Substitution test was found. In older participants, we observed a transfer to Digit Span Forward, CERAD Delayed Recall, and Digit Symbol Substitution test. Results suggest that working memory training may be a beneficial intervention for maintaining and improving cognitive functioning in old age.     

A single bout of aerobic exercise modulates motor learning performance and cortical excitability in humans

BackgroundEvidence indicates beneficial effects of aerobic exercise on motor learning performance, which might be caused by the impact of aerobic exercise on cortical excitability. It is thus suggested that physiological effects of aerobic exercise on cortical excitability determine the effects of aerobic exercise on motor learning. Nevertheless, respective results usually come from independent studies, and a prove of the causal relationship between neurophysiological and motor learning effects is still missing. This study aims to explore the impact of a single bout of aerobic exercise on brain physiology and motor learning, and the association between these phenomena in humansMethodThe study was conducted in a cross-over design. In twenty healthy subjects, cortical excitability and motor learning were assessed before and after a single bout of aerobic exercise or a control interventionResultsThe results show that aerobic exercise improved motor sequence learning and enhanced cortical excitability in humans. Furthermore, a correlation between the exercise-dependent alteration of cortical excitability (short intracortical inhibition, which is determined primarily by the GABAergic system) and improvement of motor learning has been foundDiscussionThe study found motor learning performance-improving effects of aerobic exercise, and these results might be explained by an exercised-caused alteration of cortical excitability, especially a reduction of GABA activity.     

Association between aerobic fitness and visuospatial performance in healthy older adults.

This study examined whether chronic physical exercise activity is associated with better neurocognitive performance in older adults. One hundred five men participated in 1 of 3 age groups (18-28, 35-45, and 60-73). For each age group, subjects were classified as high or low in fitness on the basis of self-reported activity levels and the results of a submaximal bicycle ergometer test. A comprehensive battery of neuropsychological tests was administered to each subject, and older subjects scored significantly lower than the younger groups on most tests. Significant differences between high- and low-fit subjects were found only on tasks with heavy visuospatial demands, and these differences were most notable in the older adult group. These findings suggest that participation in aerobic exercise activity selectively preserves some cognitive functions that normally decline with age. The benefits of activity appear to be most evident on tasks that require visuospatial processing.     

Effects of Physical Exercise on Resources Evaluation,Body Self-Concept and Well-Being Among Older Adults

This study addressed the effects of a 14-week moderate physical activity program on resources evaluation, body self-concept and other health-related psychological variables among older adults. In a quasi-experimental design participants were divided into three groups and completed questionnaires twice, before ( t 1) and after ( t 2) the 14-week program. The experimental group participated in a supervised mixed exercise program of moderate intensity. The placebo attention control group took part in a foreign language course. The no intervention control group did not get any intervention/attention at all. The dependent variables were resources evaluation, body self-concept, trait anxiety, and psychosomatic complaints. Using the pretest data as covariates multivariate analyses of covariance revealed significant improvements in body self-concept in the experimental group compared to the control groups. No other significant differences could be detected. Results point to the positive effects of exercise on body self-concept even among older adults.     

Aerobic exercise training ameliorates craving and inhibitory control in methamphetamine dependencies: A randomized controlled trial and event-related potential study

ObjectiveMethamphetamine (MA) usage has been recognized as a prominent substance-abuse issue. While exercise training reportedly improves fitness and mental status in the MA-dependent, how exercise training affects addiction and cognitive deficiency has yet to be established. The current study aimed to determine the effects of aerobic exercise training on both MA-associated cravings and inhibitory control among those with MA dependencies.DesignA 12-week randomized controlled trial.MethodSixty-two people with MA dependencies recruited through the Drug Rehabilitation Bureau were assigned to either an aerobic exercise or attentional control group, with 50 participants completing the trial. The aerobic exercise program involved three 30-min sessions of moderate-intensity exercise per week. Along with a pre-test assessment, craving levels were evaluated every three weeks, and data on neutral and MA-related inhibitory control as well as its elicited neuroelectric activation were collected at the end of the intervention.ResultsCompared with the control group, the exercise group experienced attenuated MA craving levels after 6 weeks of the exercise program, and the decreased trend was maintained until the termination of treatment. In the post-test, the exercise group also demonstrated more accuracy in behavioral inhibitory control as well as greater N2 amplitude in the Nogo condition of both the standard and MA-related tasks than those in the control group or pre-test.ConclusionsThe current study provides the first evidence that aerobic exercise training may be efficacious for MA-associated cravings and inhibitory control from behavioral and neuroelectric perspectives among MA-dependent individuals.     

Exercise Training for Persons with Alzheimer's Disease and Caregivers: A Review of Dyadic Exercise Interventions

Alzheimer's disease (AD) is the most common form of dementia and the prevalence will increase dramatically in the next decades. Although exercise has shown benefits for people with dementia due to AD as well as their caregivers, the impact of a dyadic exercise intervention including both groups as study participants remains to be determined. The authors review the current clinical evidence for dyadic exercise interventions, which are exercise regimens applied to both the person with dementia and the caregiver. A total of 4 controlled trials were reviewed. This review shows that dyadic exercise interventions are feasible and may produce a positive effect on functional independence and caregiver burden. However, there was insufficient evidence to support a benefit of dyadic exercise intervention on cognitive performance and on behavioral and neuropsychiatric symptoms in participants with dementia due to AD. A dyadic exercise intervention improves functional independence and caregiver burden. However, there is a need for well-designed randomized controlled clinical trials to confirm these benefits and to investigate several important points such as the effects of a dyadic exercise intervention on cognitive and noncognitive outcomes of AD, the optimal intensity of exercise training, and the cost effectiveness of such a program.     

Different storage and retrieval deficits in normal aging and mild cognitive impairment: a multinomial modeling analysis

The authors compared patients with mild cognitive impairment with healthy older adults and young control participants in a free recall test in order to locate potential qualitative differences in normal and pathological memory decline. Analysis with an extended multitrial version of W. H. Batchelder and D. M. Riefer's (1980) pair-clustering model revealed globally decelerated learning and an additional retrieval deficit in patients with mild cognitive impairment but not in healthy older adults. Results thus suggest differences in memory decline between normal and pathological aging that may be useful for the detection of risk groups for dementia, and they illustrate the value of model-based disentangling of processes and of multitrial tests for early detection of dementia.     

Probing the Brain Substrates of Cognitive Processes Responsible for Context Effects on Recognition Memory

ABSTRACT

Context effects on episodic recognition memory involve separable contributions of target-context binding, additive familiarity, and configural constancy. Here we examine whether these factors reflect contributions of processes attributed to different brain substrates. First, we challenged frontal and medial temporal lobe-based cognitive capacities in healthy young adults, employing divided attention tasks at encoding and retrieval, and extended retrieval delay, respectively. Target-context binding effects were specifically attenuated by delay, but not by divided attention. In a second experiment, older adults were identified by neuropsychological testing as having different levels of frontal and medial temporal lobe-dependent cognitive functions. Consistent with Experiment 1, older adults with low medial temporal lobe function exhibited reduced target-context binding effects, but levels of frontal function did not modulate binding effects. These findings indicate that unlike source memory, context effects on memory are associated with the integrity of medial temporal lobe-based processes but not with the integrity of frontal lobe-based processes. Our findings also emphasize the importance of discriminating between functional subgroups in the attempt to characterize memory processes in older adults.     

The interactive effects of age,education, and BMI on cognitive functioning

We examined the moderating effects of age and cognitive reserve on the relationship between body mass index (BMI) and processing speed, executive function, and working memory based on the literature suggesting that obese individuals perform more poorly on measures of these abilities. Fifty-six healthy, dementia-free community-dwelling older (mean age 65.72 ± 7.40) and younger (mean age 21.10 ± 2.33) adults completed a neuropsychological battery and reported height and weight. Mixed effects models were used to evaluate the interactive effects of age, education (a proxy for cognitive reserve), and BMI on cognitive scores. Higher education was protective for executive deficits in younger, but not older adults. Age differences in executive functions were reduced at higher education levels but increased in individuals with higher BMI. Results suggest the inter-relationships between cognitive reserve – as measured by education – and BMI differ across age, and that obesity may accelerate the cognitive aging process.     

Judgments of blame and forgiveness: A comparison of young adults,older adults,and older adults with dementia

IntroductionAlzheimer's disease may modify moral judgment.ObjectiveIn two studies, we assessed the impact of dementia on blame and forgiveness. Study 1 compared the ways in which young adults, older adults, and older adults with dementia cognitively integrated two factors. Study 2 assessed the number of different factors that older adults with dementia were able to integrate during these moral judgments.MethodThe participants recorded their moral judgements in a blame task and in a forgiveness task. In study 1, the two questionnaires contained scenarios built from the combination of two factors. In study 2, the participants were confronted with the same tasks under three different conditions with scenarios that combined three, four or five factors.ResultsThe data from study 1 showed that the older adults with dementia did not combine the two factors in the same way as young adults did: the combination depended on the type of moral judgment. Study 2 revealed differences in moral judgment between older adults with dementia and adults without dementia in all tasks (i.e. with three, four or five factors combined).ConclusionDementia has an impact on moral judgments. Moral judgment among people with dementia is both task- and condition-dependant.