Efficacy of cognitive training associated with physical exercises on Alzheimer's dementia: a meta-analysis
DOI:
https://doi.org/10.33448/rsd-v9i12.11022Keywords:
Alzheimer Disease; Cognition; Memory; Exercise.Abstract
Objective: To investigate the effects of cognitive training associated with physical exercise on cognitive performance of elderly people with Alzheimer's Disease (AD). Methodology: A systematic review was carried out with a meta-analysis of controlled and cross-over clinical trials. The literature search was carried out in databases Pubmed / MEDLINE, LILACS, SciELO, PEDro, Scopus, CINAHL and Web of Science, using terms MeSH / DeCS. The risk of bias was assessed according to recommendations of Cochrane Handbook for Systematic Reviews of Interventions and RevMan 5.3 software was used for the meta-analysis. . Results: Initially, 1126 articles were found, nine were chosen for qualitative synthesis and two for meta-analysis. The meta-analysis data showed significant differences in effect size for executive functions and attention, evaluated by Clock Drawing Test (Z = 3.05; p = 0.002) and frontal cognitive functions evaluated by Frontal Assessment Battery (Z = 3.56; p = 0.0004). For qualitative analysis, seven studies demonstrated positive effects of cognitive training associated with physical exercise to improve/maintain cognitive functions of elderly with AD. Conclusion: Despite the limitations found in analyzed studies, it can be suggested that cognitive training associated with physical exercise can benefit the cognitive performance of elderly with AD. However, the dearth of studies developed with greater discerning methodology limits generalizations of these results.
References
Alzheimer's Association. (2016). 2016 Alzheimer's disease facts and figures. Alzheimer's & Dementia, 12(4), 459-509. doi: 10.1016/j.jalz.2016.03.001
Bahar-Fuchs, A., Clare, L., & Woods, B. (2013). Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer's disease and vascular dementia. Cochrane Database Systematic Review(6), CD003260. doi: 10.1002/14651858.CD003260.pub2
Baker, L. D., Frank, L. L., Foster-Schubert, K., Green, P. S., Wilkinson, C. W., McTiernan, A., . . . Craft, S. (2010). Effects of aerobic exercise on mild cognitive impairment: a controlled trial. Archives of Neurology, 67(1), 71-79. doi: 10.1001/archneurol.2009.307
Cass, S. P. (2017). Alzheimer's Disease and Exercise: A Literature Review. Current Sports Medicine Reports, 16(1), 19-22. doi: 10.1249/JSR.0000000000000332
Coelho, F. G., Andrade, L. P., Pedroso, R. V., Santos-Galduroz, R. F., Gobbi, S., Costa, J. L., & Gobbi, L. T. (2013). Multimodal exercise intervention improves frontal cognitive functions and gait in Alzheimer's disease: a controlled trial. Geriatrics & Gerontology International, 13(1), 198-203. doi: 10.1111/j.1447-0594.2012.00887.x
Andrade, L. P., Gobbi, L. T., Coelho, F. G., Christofoletti, G., Costa, J. L., & Stella, F. (2013). Benefits of multimodal exercise intervention for postural control and frontal cognitive functions in individuals with Alzheimer's disease: a controlled trial. Journal of the American Geriatrics Society, 61(11), 1919-1926. doi: 10.1111/jgs.12531
Dos Santos Picanco, L. C., Ozela, P. F., de Fatima de Brito Brito, M., Pinheiro, A. A., Padilha, E. C., Braga, F. S., . . . da Silva Hage-Melim, L. I. (2018). Alzheimer's Disease: A Review from the Pathophysiology to Diagnosis, New Perspectives for Pharmacological Treatment. Current Medicinal Chemistry, 25(26), 3141-3159. doi: 10.2174/0929867323666161213101126
Du, Z., Li, Y., Li, J., Zhou, C., Li, F., & Yang, X. (2018). Physical activity can improve cognition in patients with Alzheimer's disease: a systematic review and meta-analysis of randomized controlled trials. Clinical Interventions in Aging, 13, 1593-1603. doi: 10.2147/CIA.S169565
Erickson, K. I., Weinstein, A. M., & Lopez, O. L. (2012). Physical activity, brain plasticity, and Alzheimer's disease. Archives of Medical Research, 43(8), 615-621. doi: 10.1016/j.arcmed.2012.09.008
Ferreira, B. N., Lopes, E. D. S., Henriques, I. F., Reis, M. M., Pádua, A. M., Figueiredo, F., . . . Coelho, F. G. M. (2017). Dual Task Multimodal Physical Training in Alzheimer’s Disease: Effect on Cognitive Functions and Muscle Strength. Revista Brasileira de Cineantropometria & Desempenho Humano, 19(5), 575-584.
Frese, M., Rousseau, D. M., & Wiklund, J. (2014). The emergence of evidence-based entrepreneurship. Entrepreneurship Theory and Practice, 38(2), 209-216. doi:10.1111/etap.12094
Groot, C., Hooghiemstra, A. M., Raijmakers, P. G., van Berckel, B. N., Scheltens, P., Scherder, E. J., . . . Ossenkoppele, R. (2016). The effect of physical activity on cognitive function in patients with dementia: A meta-analysis of randomized control trials. Ageing Research Reviews, 25, 13-23. doi: 10.1016/j.arr.2015.11.005
Higgins, J. P., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., & Welch, V. A. (Eds.). (2019). Cochrane handbook for systematic reviews of interventions. John Wiley & Sons.
Jia, R. X., Liang, J. H., Xu, Y., & Wang, Y. Q. (2019). Effects of physical activity and exercise on the cognitive function of patients with Alzheimer disease: a meta-analysis. BMC Geriatrics, 19(1), 181. doi: 10.1186/s12877-019-1175-2
Kampragkou, C., Iakovidis, P., Kampragkou, E., & Kellis, E. (2017). Effects of a 12-Week Aerobic Exercise Program Combined with Music Therapy and Memory Exercises on Cognitive and Functional Ability in People with Middle Type of Alzheimer's Disease. International Journal of Physiotherapy, 4. doi: 10.15621/ijphy/2017/v4i5/159420
Liang, J. H., Xu, Y., Lin, L., Jia, R. X., Zhang, H. B., & Hang, L. (2018). Comparison of multiple interventions for older adults with Alzheimer disease or mild cognitive impairment: A PRISMA-compliant network meta-analysis. Medicine (Baltimore), 97(20), e10744. doi: 10.1097/MD.0000000000010744
McGough, E. L., Lin, S. Y., Belza, B., Becofsky, K. M., Jones, D. L., Liu, M., . . . Logsdon, R. G. (2019). A Scoping Review of Physical Performance Outcome Measures Used in Exercise Interventions for Older Adults With Alzheimer Disease and Related Dementias. Journal of Geriatric Physical Therapy, 42(1), 28-47. doi: 10.1519/JPT.0000000000000159
Middleton, L. E., Black, S. E., Herrmann, N., Oh, P. I., Regan, K., & Lanctot, K. L. (2018). Centre- versus home-based exercise among people with mci and mild dementia: study protocol for a randomized parallel-group trial. BMC Geriatrics, 18(1), 27. doi: 10.1186/s12877-017-0684-0
Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., ... & Stewart, L. A. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic reviews, 4(1), 1.
Moore, R. D., Romine, M. W., O'Connor P, J., & Tomporowski, P. D. (2012). The influence of exercise-induced fatigue on cognitive function. Journal of Sports Sciences, 30(9), 841-850. doi: 10.1080/02640414.2012.675083
Nascimento, C. M., Teixeira, C. V., Gobbi, L. T., Gobbi, S., & Stella, F. (2012). A controlled clinical trial on the effects of exercise on neuropsychiatric disorders and instrumental activities in women with Alzheimer's disease. Revista Brasileira de Fisioterapia, 16(3), 197-204. doi: 10.1590/s1413-35552012005000017
Ohman, H., Savikko, N., Strandberg, T. E., Kautiainen, H., Raivio, M. M., Laakkonen, M. L., . . . Pitkala, K. H. (2016). Effects of Exercise on Cognition: The Finnish Alzheimer Disease Exercise Trial: A Randomized, Controlled Trial. Journal of the American Geriatrics Society, 64(4), 731-738. doi: 10.1111/jgs.14059
Öhman, H., Savikko, N. R. N., Strandberg, T. E., Kautiainen, H., Raivio, M. M., Laakkonen, M. L., . . . Pitkälä, K. H. (2017). Effects of frequent and long-term exercise on neuropsychiatric symptoms in patients with Alzheimer's disease–Secondary analyses of a randomized, controlled trial (FINALEX). European Geriatric Medicine, 8(2), 153-157.
Olazaran, J., Muniz, R., Reisberg, B., Pena-Casanova, J., del Ser, T., Cruz-Jentoft, A. J., . . . Sevilla, C. (2004). Benefits of cognitive-motor intervention in MCI and mild to moderate Alzheimer disease. Neurology, 63(12), 2348-2353. doi: 10.1212/01.wnl.0000147478.03911.28
Paiva, F. F., de Albuquerque Pereira, I. C. R., da Silva, J. M. L., da Silva Cruz, L. B., Costa, T. S., Maia, C. C., ... & Panzetti, T. M. N. (2020). Atividades lúdicas como estratégia terapêutica paliativa na mitigação dos processos crônico-degenerativos da doença de Alzheimer. Research, Society and Development, 9(7), e580974547-e580974547.
Silva, D. O., Barbieri, F. A., Simieli, L., dos Santos, P. C. R., Beretta, V. S., Coelho, F. G. M., . . . Gobbi, L. T. B. (2018). A program of physical activity improves gait impairment in people with Alzheimer's disease. Motriz, 24(1), 1-6.
Silva, M. V. F., Loures, C. M. G., Alves, L. C. V., de Souza, L. C., Borges, K. B. G., & Carvalho, M. D. G. (2019). Alzheimer's disease: risk factors and potentially protective measures. Journal of Biomedical Science, 26(1), 33. doi: 10.1186/s12929-019-0524-y
Silva, L. W. S., Nascimento, T. R., Valença, T. D. C., Alves, L. F. S., Pires, N. O., da Silva, A. G., ... & Santos, F. M. (2020). Efeitos do exercício físico na alteração postural e funcionalidade de idosos: cuidados ao longeviver saudável. Research, Society and Development, 9(8), e48985329-e48985329.
Suetta, C., Clemmensen, C., Andersen, J. L., Magnusson, S. P., Schjerling, P., & Kjaer, M. (2010). Coordinated increase in skeletal muscle fiber area and expression of IGF-I with resistance exercise in elderly post-operative patients. Growth Hormone and IGF Research, 20(2), 134-140. doi: 10.1016/j.ghir.2009.11.005
Ward, N., Paul, E., Watson, P., Cooke, G. E., Hillman, C. H., Cohen, N. J., . . . Barbey, A. K. (2017). Enhanced Learning through Multimodal Training: Evidence from a Comprehensive Cognitive, Physical Fitness, and Neuroscience Intervention. Scientific Reports, 7(1), 5808. doi: 10.1038/s41598-017-06237-5
Wu, C., Yi, Q., Zheng, X., Cui, S., Chen, B., Lu, L., & Tang, C. (2019). Effects of Mind-Body Exercises on Cognitive Function in Older Adults: A Meta-Analysis. Journal of the American Geriatrics Society, 67(4), 749-758. doi: 10.1111/jgs.15714
Yorozuya, K., Kubo, Y., Tomiyama, N., Yamane, S., & Hanaoka, H. (2019). A Systematic Review of Multimodal Non-Pharmacological Interventions for Cognitive Function in Older People with Dementia in Nursing Homes. Dementia and Geriatric Cognitive Disorders, 48(1-2), 1-16. doi: 10.1159/000503445
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Copyright (c) 2020 Ana Gonçalves Lima Neta; Mírian Celly Medeiros Miranda David; Bruna Thays Santana de Araújo; Gabriela Lopes Gama; Jéssica Costa Leite
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