Effect of aerobic exercise on post-stroke cognitive function: a systematic review

2020 ◽  
Vol 27 (9) ◽  
pp. 1-15
Author(s):  
Muhammad Aliyu Abba ◽  
Olubukola Adebisi Olaleye ◽  
Talhatu Kolapo Hamzat

Background/Aims Literature suggests that aerobic exercise improves cognitive impairments post stroke. This systematic review was conducted to analyse evidence on the effectiveness of aerobic exercise in improving post-stroke cognitive impairments. Methods Online databases (PubMed, EMBASE and Web of Science) were systematically searched from inception until 13 July 2017 using the keywords stroke/exercise/cognition. Clinical trials that met the inclusion criteria were assessed for methodological quality using the PEDro scale. Extracted data were synthesised for evidence. Results A total of seven studies met the inclusion criteria. Participants in most of the studies were aged over 60 years and the majority had ischaemic stroke. The most commonly used measure for assessing cognition was the Mini Mental State Examination. The majority of studies included moderate to high intensity exercise (50–70% of VO2max) for 30–60 minutes three to five times per week. There is moderate evidence that aerobic exercise enhances global cognitive function, attention and working memory. Evidence that aerobic exercise improves memory, levels of brain-derived neurotrophic factor and executive function is conflicting and limited. Conclusions Aerobic exercise is moderately effective in improving post-stroke cognitive impairments. More clinical trials are needed in view of the methodological limitations and paucity of existing studies.

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Raden Ayu Tanzila ◽  
Sheilla Yonaka Lindri ◽  
Nindia Rahma Putri

In the elderly population, at least 10% of those over 65 years old and 50% of those over 80 years old experience a decline in cognitive function that varies from a cognitive decline due to normal aging (age-associated memory impairment/AAMI) to a mild cognitive decline (mild cognitive impairment/MCI) and dementia. Dementia is an intellectual disorder that affects the cognitive function, memory, language function, and visuospatial function that causes irreversible changes. Many studies have stated that lifestyle management in the form of increased physical activity has a protective effect on impaired cognitive functions, inhibits cognitive function decline, and even improves cognitive function in healthy elderly people and elderly with mild cognitive impairment to dementia. Low impact aerobic exercise is a physical activity that is useful and suitable for the elderly. This study aimed to determine the effect of low impact aerobic exercise on the cognitive function of elderly people with dementia. This was a quasi-experimental study with one group pretest-posttest method that involved elderly people from Tresna Werdha Teratai Palembang, South Sumatera, Indonesia who were selected based on the inclusion and exclusion criteria (n=38) from December 2018 to February 2019. Treatment provided was a low impact aerobic exercise 3 times a week for 5 weeks. Dementia was then measured before and after treatment using the Mini-mental State Examination (MMSE). The mean values of gymnastics before the treatment and after the treatment were 18.36±4.559 and 19.69±5.724, respectively. A p value of 0.000 was obtained using the Wilcoxon test. In summary, low impact aerobic exercise influences the cognitive function of the elderly with dementia. PENGARUH SENAM AEROBIK LOW IMPACT TERHADAP FUNGSI KOGNITIF USILA DENGAN DEMENSIAPada usia lanjut (usila), sedikitnya 10% dari yang berusia lebih dari 65 tahun dan 50% dari yang berusia lebih dari 80 tahun mengalami penurunan fungsi kognitif yang bervariasi mulai dari penurunan kognitif karena penuaan normal (age-associate memory impairment/AAMI) serta penurunan kognitif ringan (mild cognitive impairment/MCI) hingga demensia. Demensia adalah gangguan intelektual yang meliputi fungsi kognitif, daya ingat, bahasa, fungsi visuospasial, dan bersifat ireversibel. Banyak studi menyatakan bahwa manajemen gaya hidup berupa peningkatan aktivitas fisik mempunyai efek protektif terhadap gangguan fungsi kognitif, menghambat penurunan fungsi kognitif, serta bahkan meningkatkan fungsi kognitif pada usila yang sehat dan usila dengan penurunan fungsi kognitif ringan sampai demensia. Senam aerobik low impact merupakan aktifitas fisik yang bermanfaat dan cocok diberikan kepada usila. Penelitian ini bertujuan mengetahui pengaruh senam aerobik low impact terhadap fungsi kognitif usila dengan demensia. Penelitian ini merupakan studi quasi-experimental dengan metode pretest-posttest one group yang melibatkan usila dari Tresna Werdha Teratai Palembang, Sumatera Selatan, Indonesia yang dipilih berdasar atas kriteria inklusi dan eksklusi (n=38) dari bulan Desember 2018 hingga Februari 2019. Perlakuan yang diberikan berupa senam aerobik low impact 3 kali per minggu selama 5 minggu. Demensia kemudian diukur sebelum dan sesudah perlakuan menggunakan Mini-mental State Examination (MMSE). Nilai rerata senam sebelum perlakuan dan setelah perlakuan adalah 18,36±4,559 dan 19,69±5,724 masing-masing. Nilai p=0,000 didapatkan dengan menggunakan Uji Wilcoxon. Simpulan, senam aerobik low impact memengaruhi fungsi kognitif usila dengan demensia.


2021 ◽  
pp. 174749302098455
Author(s):  
Nick A Weaver ◽  
Angelina K Kancheva ◽  
Jae-Sung Lim ◽  
J Matthijs Biesbroek ◽  
Irene MC Huenges Wajer ◽  
...  

Background Post-stroke cognitive impairment can occur after damage to various brain regions, and cognitive deficits depend on infarct location. The Mini-Mental State Examination (MMSE) is still widely used to assess post-stroke cognition, but it has been criticized for capturing only certain cognitive deficits. Along these lines, it might be hypothesized that cognitive deficits as measured with the MMSE primarily involve certain infarct locations. Aims This comprehensive lesion-symptom mapping study aimed to determine which acute infarct locations are associated with post-stroke cognitive impairment on the MMSE. Methods We examined associations between impairment on the MMSE (<5th percentile; normative data) and infarct location in 1198 patients (age 67 ± 12 years, 43% female) with acute ischemic stroke using voxel-based lesion-symptom mapping. As a frame of reference, infarct patterns associated with impairments in individual cognitive domains were determined, based on a more detailed neuropsychological assessment. Results Impairment on the MMSE was present in 420 patients (35%). Large voxel clusters in the left middle cerebral artery territory and thalamus were significantly (p < 0.01) associated with cognitive impairment on the MMSE, with highest odds ratios (>15) in the thalamus and superior temporal gyrus. In comparison, domain-specific impairments were related to various infarct patterns across both hemispheres including the left medial temporal lobe (verbal memory) and right parietal lobe (visuospatial functioning). Conclusions Our findings indicate that post-stroke cognitive impairment on the MMSE primarily relates to infarct locations in the left middle cerebral artery territory. The MMSE is apparently less sensitive to cognitive deficits that specifically relate to other locations.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fatima Nari ◽  
Bich Na Jang ◽  
Hin Moi Youn ◽  
Wonjeong Jeong ◽  
Sung-In Jang ◽  
...  

AbstractFrailty is considered a multidimensional geriatric syndrome, manifested by the accumulation of age-associated deficits. The consequences of frailty transitions are still understudied. This study evaluated the influence of frailty transitions on cognitive function in the older adult population. We used data derived from the Korean Longitudinal Study of Aging (KLoSA) (2008–2018) on older adults aged ≥ 65 years. Frailty was assessed using a validated Korean frailty measure known as the frailty instrument (FI), and cognitive function was measured using the Korean version of the Mini-Mental State Examination (K-MMSE). Transitions in frailty and their relationship with cognitive function were investigated using lagged generalized estimating equations (GEE), t-tests, and ANOVA. Respondents who experienced frailty transitions (those with ameliorating frailty), those who developed frailty, and whose frailty remained constant, were more likely to have a lower cognitive function than those who were consistently non-frail. Older age, activities of daily living (ADL) disability, and instrumental ADL disability were more negatively associated with declining cognitive function, especially in the “frail → frail” group. Changes in all individual components of the frailty instrument were significantly associated with impaired cognitive function. The results suggest an association between frailty transitions and cognitive impairment. Over a 2-year span, the remaining frail individuals had the highest rate of cognitive decline in men, while the change from non-frail to frail state in women was significantly associated with the lowest cognitive function values. We recommend early interventions and prevention strategies in older adults to help ameliorate or slow down both frailty and cognitive function decline.


2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Mohamed W. Zakaria ◽  
Reem I. El-Korashy ◽  
Mostafa O. Shaheen ◽  
Samah Selim ◽  
Kwashi J. Amum

Abstract Background Cognitive dysfunction in idiopathic interstitial pneumonia (IIP) is an important clinical co-morbidity that is associated with impaired lung function. The aim of the work is to assess cognitive function in major IIP and to find out the relation between cognitive dysfunction and the oxygenation parameters. Results Fifty individuals were involved in the study; 30 patients with major IIP and 20 healthy individuals. Patients with IIP had significantly lower mini mental state examination (MMSE) score compared to the control group (P < 0.001). Wechsler Deterioration Index (WDI) revealed that 33.3% (n = 10) of the patients with IIP had sure cognitive impairment and 26.6% (n = 8) had ongoing cognitive deterioration. Patients with idiopathic pulmonary fibrosis (IPF) had lower cognitive function than other IIP. Conclusion There is an impairment of cognitive function in patients with major IIP, particularly in IPF, as measured by WDI and MMSE. Further large studies are needed to assess the possible predictors of cognitive impairment and their effects on the patients’ outcome.


2019 ◽  
Author(s):  
Carlota Grossi ◽  
Kathryn Richardson ◽  
George Savva ◽  
Chris Fox ◽  
Antony Arthur ◽  
...  

Abstract Background: Anticholinergic medication use is linked with increased cognitive decline, dementia, falls and mortality. The characteristics of the population who use anticholinergic medication are not known. Here we estimate the prevalence of anticholinergic use in England’s older population in 1991 and 2011, and describe changes in use by participant’s age, sex, cognition and disability. Methods: We compared data from participants aged 65+ years from the Cognitive Function and Ageing Studies (CFAS I and II), collected during 1990-1993 (N=7,635) and 2008-2011 (N=7,762). We estimated the prevalence of potent anticholinergic use (Anticholinergic Cognitive Burden [ACB] score=3) and average anticholinergic burden (sum of ACB scores), using inverse probability weights standardised to the 2011 UK population. These were stratified by age, sex, Mini-Mental State Examination score, and activities of daily living (ADL) or instrumental ADL (IADL) disability. Results: Prevalence of potent anticholinergic use increased from 5.7% (95% Confidence Interval [CI] 5.2-6.3%) of the older population in 1990-93 to 9.9% (9.3-10.7%) in 2008-11, adjusted odds ratio of 1.90 (95%CI 1.67 – 2.16). People with clinically significant cognitive impairment (MMSE [Mini Mental State Examination] 21 or less) were the heaviest users of potent anticholinergic in CFAS II (16.5% [95%CI 12.0-22.3%]). Large increases in the prevalence of the use medication with ‘any’ anticholinergic activity were seen in older people with clinically significant cognitive impairment (53.3% in CFAS I to 71.5% in CFAS II). Conclusions: Use of potent anticholinergic medications nearly doubled in England’s older population over 20 years with some of the greatest increases amongst those particularly vulnerable to anticholinergic side-effects. Key words: cognitive impairment, anticholinergic burden, polypharmacy


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Muhammad Mikail Athif Zhafir Asyura ◽  
Angelina Patricia Chandra ◽  
Achmad Agussalim ◽  
Garry Soloan

Introduction: The lingering Severe Acute Respiratory System-Coronavirus-2 (SARS-CoV-2) pandemic worldwide has called scientists to accelerate vaccine production and reduce the spread of the virus. The inactivated virus vaccine has been administered widely due to its potency. Following its recent public use, we aim to summarize the efficacy and safety of the inactivated vaccine, especially following Indonesia’s settlement on the SinoVac vaccine. Materials and Methods: A systematic review was performed, searching for randomized controlled trials, according to the PRISMA statement throughout four online databases with studies published up to 2 February 2021. Critical appraisal was further conducted utilizing the Cochrane Risk of Bias Tool 2.0. Results and Discussions: The search yielded six phase ½ clinical trials with a total of 3251 subjects. The outcome was obtained in seroconversion rates (%) after two doses of vaccine. Four studies administered the CoronaVac inactivated vaccine and resulted in a high seroconversion rate, ranging from 89—90%. The other two studies administered the BBV152 and BBIBP-CorV inactivated vaccine and showed similar results. Furthermore, a dose dependent relation is shown with higher doses showing higher seroconversion rates. The safety analysis reported injection site pain as an insignificant but most prevalent local adverse reaction, with other adverse reactions being mild to moderate respiratory tract infections Conclusion: The inactivated vaccine’s efficacy has been proven to stimulate antibody response regardless of dosage, period of administration, and age, with insignificant adverse effects. Further phase 3 clinical trials and widespread administration with the help of non-governmental and medical student organizations are recommended


Author(s):  
Minoru Yamakado

Objective: An important medical issue in both Japan and Ashikaga City is how to extend healthy life expectancy. To determine factors associated with healthy life expectancy, we established a joint study between Ashikaga City and the Ashikaga University Faculty of Nursing called the Ashikaga Longevity Study, using new biomarkers such as Diacron reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) tests as indicators of oxidative stress. In this study, factors related to cognitive function were clarified. Methods: Participants comprised 95 individuals (36 men; mean age, 91.0±5.1 years and 59 women; mean age, 92.2±5.9 years). Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE). Results: MMSE score was ≤23 in 28 subjects (29.5%) and ≥24 in 67 subjects (70.5%). MMSE score showed significant negative correlations with age (p<0.0096), plasma alkaline phosphatase (p=0.0007), and peripheral leukocyte-to-lymphocyte ratio (p=0.0119), and positive correlations with plasma albumin (p=0.0096) and BAP-to-d-ROMs ratio (p=0.0427). Conclusions: These results suggest that cognitive decline may involve brain cell dysfunction due to inflammation based on a reduced ability to control oxidative stress. Not only anti-oxidative aerobic exercise but also anti-oxidative foods, may be necessary to maintain cognitive function.


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