From the December Issue of JAMDA

Abstract

Physical Training Improves Cognitive ImpairmentHigh-intensity progressive resistance training can improve global cognition, executive function, and verbal and constructional memory in older adults who have mild cognitive impairment. This is according to findings from the Study of Mental and Resistance Training (SMART) trial of adults in Australia who have mild cognitive impairment.Maria A. Fiatarone Singh, MD, of the Exercise, Health and Performance Group, Faculty of Health Sciences, and Sydney Medical School at the University of Sydney, and her colleagues designed the randomized, double-blind, double-sham-controlled trial to examine the effects of cognitive training and resistance training, both alone and combined, in individuals with mild cognitive impairment.“In the absence of any definitive treatment for dementia, attention is increasingly focused on low risk and cost effective primary and secondary prevention strategies,” Dr. Fiatarone Singh said in a letter to the JAMDA editors. “A recent systematic review of this area identified suboptimal mental and physical activity as the first and third most important modifiable risk factors for dementia globally, with modeling to suggest that reducing worldwide prevalence of both by merely 10% could translate to more than 900,000 fewer dementia cases.”The researchers randomized 100 individuals with mild cognitive impairment to receive high-intensity progressive resistance training or sham training (seated calisthenics) plus computerized, multidomain cognitive training or sham training (watching videos and quizzes) 2 to 3 days a week for 6 months, with 18-month follow-up.“Both interventions were theoretically designed and evidence-based to optimally stimulate both physiological and neurocognitive processes we hypothesized would contribute independently to cognitive decline in this cohort,” Dr. Fiatarone Singh said.Progressive resistance training significantly improved global and executive function, both after training and at follow-up, the researchers found. For example, the number of individuals with normal scores on the Alzheimer's Disease Assessment Scale (ADAS-Cog), which the researchers used to measure global function, doubled from 24% to 48% after resistance training vs. an increase of 7%, to 27%, in those who received sham training.By contrast, there was no difference in scores among those who received cognitive vs. sham training. Cognitive training only attenuated decline in overall memory domain score at 6 months. Also, there was no significant effect of cognitive training on executive function.A surprising finding: The benefit of resistance training alone on executive domain was 74% higher than that of combined physical and cognitive training at 18 months and 48% higher for global domain score.The researchers believe that more large-scale trials are warranted to confirm these findings, explore the mechanism of cognitive and neural adaptations to PRT, and demonstrate that progressive resistance training can reduce incident dementia in this high-risk cohort.▸ Source: The Study of Mental and Resistance Training (SMART) Study – Resistance Training and/or Cognitive Training in Mild Cognitive Impairment: A Randomized, Double-blind, Double-sham Controlled Trial – Fiatarone Singh MA, et al.Diet Affects FrailtyAdherence to a Mediterranean diet may reduce the risk of frailty in older individuals, according to results of a prospective cohort study in Spain.Led by Luz M. León-Muñoz, PhD, of the Biomedical Research Centre Network for Epidemiology and Public Health in Madrid, researchers measured adherence to a Mediterranean diet among 1,810 individuals aged 60 years and older using the Mediterranean Diet Adherence Screener (MEDAS) score and the Mediterranean Diet Score, then examined the association between adherence and frailty risk.Over 3.5 years follow-up, the researchers identified 137 individuals with incident frailty. The odds ratio for frailty using either score was lower among those who were most adherent to the diet vs. those who were least adherent. Also, a higher MEDAS score was associated with lower risk of slow walking speed and of weight loss, whereas greater consumption of fish and fruits and vegetables was associated with lower risk of incident frailty.Possible reasons for the association between diet and reduced frailty risk include intake of micronutrients and protein known to reduce the risk of frailty, and reduced risk of developing chronic diseases that may lead to frailty.▸ Source: Mediterranean Diet and Risk of Frailty in Community-Dwelling Older Adults – León-Muñoz LM, et al. Physical Training Improves Cognitive ImpairmentHigh-intensity progressive resistance training can improve global cognition, executive function, and verbal and constructional memory in older adults who have mild cognitive impairment. This is according to findings from the Study of Mental and Resistance Training (SMART) trial of adults in Australia who have mild cognitive impairment.Maria A. Fiatarone Singh, MD, of the Exercise, Health and Performance Group, Faculty of Health Sciences, and Sydney Medical School at the University of Sydney, and her colleagues designed the randomized, double-blind, double-sham-controlled trial to examine the effects of cognitive training and resistance training, both alone and combined, in individuals with mild cognitive impairment.“In the absence of any definitive treatment for dementia, attention is increasingly focused on low risk and cost effective primary and secondary prevention strategies,” Dr. Fiatarone Singh said in a letter to the JAMDA editors. “A recent systematic review of this area identified suboptimal mental and physical activity as the first and third most important modifiable risk factors for dementia globally, with modeling to suggest that reducing worldwide prevalence of both by merely 10% could translate to more than 900,000 fewer dementia cases.”The researchers randomized 100 individuals with mild cognitive impairment to receive high-intensity progressive resistance training or sham training (seated calisthenics) plus computerized, multidomain cognitive training or sham training (watching videos and quizzes) 2 to 3 days a week for 6 months, with 18-month follow-up.“Both interventions were theoretically designed and evidence-based to optimally stimulate both physiological and neurocognitive processes we hypothesized would contribute independently to cognitive decline in this cohort,” Dr. Fiatarone Singh said.Progressive resistance training significantly improved global and executive function, both after training and at follow-up, the researchers found. For example, the number of individuals with normal scores on the Alzheimer's Disease Assessment Scale (ADAS-Cog), which the researchers used to measure global function, doubled from 24% to 48% after resistance training vs. an increase of 7%, to 27%, in those who received sham training.By contrast, there was no difference in scores among those who received cognitive vs. sham training. Cognitive training only attenuated decline in overall memory domain score at 6 months. Also, there was no significant effect of cognitive training on executive function.A surprising finding: The benefit of resistance training alone on executive domain was 74% higher than that of combined physical and cognitive training at 18 months and 48% higher for global domain score.The researchers believe that more large-scale trials are warranted to confirm these findings, explore the mechanism of cognitive and neural adaptations to PRT, and demonstrate that progressive resistance training can reduce incident dementia in this high-risk cohort.▸ Source: The Study of Mental and Resistance Training (SMART) Study – Resistance Training and/or Cognitive Training in Mild Cognitive Impairment: A Randomized, Double-blind, Double-sham Controlled Trial – Fiatarone Singh MA, et al. High-intensity progressive resistance training can improve global cognition, executive function, and verbal and constructional memory in older adults who have mild cognitive impairment. This is according to findings from the Study of Mental and Resistance Training (SMART) trial of adults in Australia who have mild cognitive impairment. Maria A. Fiatarone Singh, MD, of the Exercise, Health and Performance Group, Faculty of Health Sciences, and Sydney Medical School at the University of Sydney, and her colleagues designed the randomized, double-blind, double-sham-controlled trial to examine the effects of cognitive training and resistance training, both alone and combined, in individuals with mild cognitive impairment. “In the absence of any definitive treatment for dementia, attention is increasingly focused on low risk and cost effective primary and secondary prevention strategies,” Dr. Fiatarone Singh said in a letter to the JAMDA editors. “A recent systematic review of this area identified suboptimal mental and physical activity as the first and third most important modifiable risk factors for dementia globally, with modeling to suggest that reducing worldwide prevalence of both by merely 10% could translate to more than 900,000 fewer dementia cases.” The researchers randomized 100 individuals with mild cognitive impairment to receive high-intensity progressive resistance training or sham training (seated calisthenics) plus computerized, multidomain cognitive training or sham training (watching videos and quizzes) 2 to 3 days a week for 6 months, with 18-month follow-up. “Both interventions were theoretically designed and evidence-based to optimally stimulate both physiological and neurocognitive processes we hypothesized would contribute independently to cognitive decline in this cohort,” Dr. Fiatarone Singh said. Progressive resistance training significantly improved global and executive function, both after training and at follow-up, the researchers found. For example, the number of individuals with normal scores on the Alzheimer's Disease Assessment Scale (ADAS-Cog), which the researchers used to measure global function, doubled from 24% to 48% after resistance training vs. an increase of 7%, to 27%, in those who received sham training. By contrast, there was no difference in scores among those who received cognitive vs. sham training. Cognitive training only attenuated decline in overall memory domain score at 6 months. Also, there was no significant effect of cognitive training on executive function. A surprising finding: The benefit of resistance training alone on executive domain was 74% higher than that of combined physical and cognitive training at 18 months and 48% higher for global domain score. The researchers believe that more large-scale trials are warranted to confirm these findings, explore the mechanism of cognitive and neural adaptations to PRT, and demonstrate that progressive resistance training can reduce incident dementia in this high-risk cohort. ▸ Source: The Study of Mental and Resistance Training (SMART) Study – Resistance Training and/or Cognitive Training in Mild Cognitive Impairment: A Randomized, Double-blind, Double-sham Controlled Trial – Fiatarone Singh MA, et al. Diet Affects FrailtyAdherence to a Mediterranean diet may reduce the risk of frailty in older individuals, according to results of a prospective cohort study in Spain.Led by Luz M. León-Muñoz, PhD, of the Biomedical Research Centre Network for Epidemiology and Public Health in Madrid, researchers measured adherence to a Mediterranean diet among 1,810 individuals aged 60 years and older using the Mediterranean Diet Adherence Screener (MEDAS) score and the Mediterranean Diet Score, then examined the association between adherence and frailty risk.Over 3.5 years follow-up, the researchers identified 137 individuals with incident frailty. The odds ratio for frailty using either score was lower among those who were most adherent to the diet vs. those who were least adherent. Also, a higher MEDAS score was associated with lower risk of slow walking speed and of weight loss, whereas greater consumption of fish and fruits and vegetables was associated with lower risk of incident frailty.Possible reasons for the association between diet and reduced frailty risk include intake of micronutrients and protein known to reduce the risk of frailty, and reduced risk of developing chronic diseases that may lead to frailty.▸ Source: Mediterranean Diet and Risk of Frailty in Community-Dwelling Older Adults – León-Muñoz LM, et al. Adherence to a Mediterranean diet may reduce the risk of frailty in older individuals, according to results of a prospective cohort study in Spain. Led by Luz M. León-Muñoz, PhD, of the Biomedical Research Centre Network for Epidemiology and Public Health in Madrid, researchers measured adherence to a Mediterranean diet among 1,810 individuals aged 60 years and older using the Mediterranean Diet Adherence Screener (MEDAS) score and the Mediterranean Diet Score, then examined the association between adherence and frailty risk. Over 3.5 years follow-up, the researchers identified 137 individuals with incident frailty. The odds ratio for frailty using either score was lower among those who were most adherent to the diet vs. those who were least adherent. Also, a higher MEDAS score was associated with lower risk of slow walking speed and of weight loss, whereas greater consumption of fish and fruits and vegetables was associated with lower risk of incident frailty. Possible reasons for the association between diet and reduced frailty risk include intake of micronutrients and protein known to reduce the risk of frailty, and reduced risk of developing chronic diseases that may lead to frailty. ▸ Source: Mediterranean Diet and Risk of Frailty in Community-Dwelling Older Adults – León-Muñoz LM, et al.