Abstract
Prolonged periods of physical inactivity or bed rest can lead to a significant decline of functional and cognitive functions. Different kinds of countermeasures (e.g., centrifugation, nutritional, and aerobic interventions) have been developed to attempt to mitigate negative effects related to bed rest confinement. The aim of this report is to provide an overview of the current evidence related to the effectiveness of computerized cognitive training (CCT) intervention during a period of complete physical inactivity in older adults. CCT, using a virtual maze navigation task, appears to be effective and has long-lasting benefits (up to 1.5 years after the study). Moreover, enhanced cognition (executive control) reduces decline in the ability to perform complex motor-cognitive dual-tasks after prolonged period of bed rest. It has been demonstrated that CCT administration in older adults also prevents bed rest stress-related physiological changes [these groups showed minimal changes in vascular function and an unchanged level of brain-derived neurotrophic factor (BDNF)] while control subjects showed decreased peripheral vascularization and increased plasma level of the neurotrophin BDNF during a 14-day bed rest. In addition, the effects of CCT are evident also from the brain electrocortical findings: CCT group revealed a decreased power in lower delta and theta bands while significant increases in the same EEG spectral bands power were found in control subjects. If we consider an increase of power in delta band as a marker of cortical aging, then the lack of shift of EEG power to lower band indicates a preventive role of CCT on the cortical level during physiological deconditioning induced by 2-week bed rest immobilization. However, replication on a larger sample is required to confirm the observed findings. Applications derived from these findings could be appropriate for implementation of hospital treatment for bed ridden patients as well as for fall prevention programs.
Highlights
Hospitalization and prolonged bed rest represent major risk factors for older persons, often resulting in irreversible deterioration in functional status and a significant decline in the quality of life (Blain et al, 2016; Bousquet et al, 2017; Goswami, 2017; Goswami et al, 2017)
The bed rest model was first introduced in the 1960s to simulate acute adaptations to the microgravity environment involved in space flights (Adams et al, 2003; Goswami et al, 2015a)
Cognitive training aimed at optimizing cognitive functioning and/or slowing brain aging has been extensively used, especially with healthy older adults
Summary
Hospitalization and prolonged bed rest represent major risk factors for older persons, often resulting in irreversible deterioration in functional status and a significant decline in the quality of life (Blain et al, 2016; Bousquet et al, 2017; Goswami, 2017; Goswami et al, 2017). Past bed rest studies included young and healthy participants and were designed to simulate the microgravitational environment and its accompanying effects, relevant for space flight missions (Blaber et al, 2013; Goswami et al, 2013; Cvirn et al, 2015; O’shea et al, 2015; Waha et al, 2015) Both horizontal and headdown tilt bed rest protocols have been implemented. The primary application of such scientific knowledge is to provide the basis for the development of possible countermeasures both for the negative consequences of bed rest confinement and space flight microgravity, in particular in regard to negative bed rest effects in older persons during hospitalization Such countermeasures are potentially extendable to addressing important consequences of the aging process in general. Emphasis is placed in this review on cognitive countermeasures to prevent cognitive and sensorimotor adaptations that occur during acute and chronic situations involving hospitalization, prolonged physical inactivity, and the general aging process
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