Function In Healthy Older Adults Research Articles

Blood-Brain Barrier Permeability Is Associated With Cognitive Functioning in Normal Aging and Neurodegenerative Diseases.

The purpose of this study was to investigate the relationship between blood-brain barrier (BBB) permeability and cognitive functioning in healthy older adults and individuals with neurodegenerative diseases. A total of 124 participants with Alzheimer disease, cerebrovascular disease, or a mix Alzheimer's and cerebrovascular diseases and 55 controlparticipants underwent magnetic resonance imaging and neuropsychological testing. BBB permeability was measured with dynamic contrast-enhanced magnetic resonance imaging and white matter injury was measured using a quantitative diffusion-tensor imaging marker of white matter injury. Structural equation modeling was used to examine the relationships between BBB permeability, vascular risk burden, white matter injury, and cognitive functioning. Vascular risk burden predicted BBB permeability (r=0.24, P<0.05) and white matter injury (r=0.38, P<0.001). BBB permeability predicted increased white matter injury (r=0.34, P<0.001) and increased white matter injury predicted lower cognitive functioning (r=-0.51, P<0.001). The study provides empirical support for a vascular contribution to white matter injury and cognitive impairment, directly or indirectly via BBB permeability. This highlights the importance of targeting modifiable vascular risk factors to help mitigate future cognitive decline.

Exercise-induced cortical disinhibition mediates the relationship between fitness and memory in older adults.

Regular exercise benefits learning and memory in older adults, but the neural mechanisms mediating these effects remain unclear. Evidence in young adults indicates that acute exercise creates a favourable environment for synaptic plasticity by enhancing cortical disinhibition. As such, we investigated whether plasticity-related disinhibition mediated the relationship between cardiorespiratory fitness and memory function in healthy older adults (n=16, mean age=66.06). Participants completed a graded maximal exercise test and assessments of visual and verbal memory, followed by two counterbalanced sessions involving 20min of either high-intensity interval training exercise or rest. Disinhibition was measured following intermittent theta burst stimulation via paired-pulse transcranial magnetic stimulation. In line with our hypotheses, we observed a positive correlation between cardiorespiratory fitness and verbal memory, which was mediated by plasticity-related cortical disinhibition. Our novel finding implicates cortical disinhibition as a mechanism through which the effects of acute bouts of exercise may translate to improved memory in older adults. This finding extends current understanding of the physiological mechanisms underlying the positive influence of cardiorespiratory fitness for memory function in older adults, and further highlights the importance of promoting exercise engagement to maintain cognitive health in later life. KEY POINTS: There are well established benefits of regular exercise for memory function in older adults, but the mechanisms are unclear. Cortical disinhibition is important for laying down new memories, and is enhanced following acute exercise in young adults, suggesting it is a potential mechanism underlying these benefits in ageing. Older adults completed a fitness test and assessments of memory, followed by two sessions involving either 20min of exercise or rest. Disinhibition was measured following intermittent theta burst stimulation via paired-pulse transcranial magnetic stimulation. Cardiorespiratory fitness was positively associated with memory performance. Higher fitness was associated with enhanced cortical disinhibition following acute exercise. Cortical disinhibition completely mediated the relationship between fitness and memory. This novel finding provides a mechanistic account for the positive influence of cardiorespiratory fitness on memory in later life, and emphasises the importance of regular exercise for cognitive health in older populations.

Changes in EEG Activity and Cognition Related to Physical Activity in Older Adults: A Systematic Review.

Aging is generally associated with a decline in important cognitive functions that can be observed in EEG. Physical activity in older adults should be considered one of the main strategies to promote health and prevent disease in the elderly. The present study aimed to systematically review studies of EEG activity and cognitive function changes associated with physical activity in older adults. Records from PubMed, Scopus, and EBSCO databases were searched and, following the PRISMA guidelines, nine studies were included in the present systematic review. A risk of bias assessment was performed using the National Institute of Health Quality Assessment Tool for Case-control Studies instrument. The studies analyzed used two main strategies to determine the effects of physical activity on cognition and EEG: (1) multiscale entropy and power frequencies; and (2) event-related potentials. In terms of EEG activity, it can be concluded that exercise-induced neuroplasticity underlies improvements in cognitive function in healthy older adults.

The Interplay between Gut Microbiota and Cognitive Functioning in the Healthy Aging Population: A Systematic Review.

The gut microbiota in healthy older individuals typically show a decrease in beneficial bacteria like Bifidobacterium and Lactobacillus, alongside an increase in pro-inflammatory microbes such as Enterobacteriaceae and Clostridia. These changes contrast with younger and middle-aged individuals and appear to correlate with cognitive status. Although there is extensive research on gut microbiota and cognitive functions in cognitively impaired elderly individuals, its impact on cognitively healthy elderly populations has not been extensively studied. A comprehensive literature search was conducted across PubMed, EBSCO, Web of Science, and Scopus databases to identify studies exploring the relationship between gut microbiota composition and cognitive functioning in healthy older adults. During the literature screening process, each record was initially assessed by its title, abstract, and keywords to exclude articles that did not align with the scope of this review. Three authors independently screened and retrieved the records. The inclusion criteria included: (1) publication in peer-reviewed journals; (2) studies involving neurologically, cognitively, and medically healthy populations; (3) participants identified as older adults, defined for this review as individuals aged 45 years and older due to the limited number of records; (4) analysis of gut microbiota; and (5) assessment of cognitive function. Subsequently, full texts were analyzed to determine eligibility. The exclusion criteria encompassed: (1) incorrect publication type; (2) inappropriate sample population; (3) unsuitable study design; (4) absence of one or more inclusion criteria; and (5) studies based on animal research. A risk of bias assessment was performed for each included study using the Joanna Briggs Institute (JBI) checklist, ensuring all selected studies met established quality standards. A total of 6 eligible research articles from a possible 1752 published until March 2024 were identified and included. We categorized the included studies into two groups based on their focus: the taxonomic composition of gut microbiota and the alpha diversity, which is the variety of organisms within a sample. Additionally, two methods were identified for assessing cognition: neuropsychological tests and physiological measurements, notably electroencephalography (EEG). The studies show varying results regarding the abundance of specific bacterial taxa and their cognitive associations. Notably, the relationship between certain bacteria and cognition may vary when analyzed at different taxonomic levels, such as phylum versus family. Changes in gut microbiota composition in the elderly, even without a cognitive impairment diagnosis, could potentially serve as early biological markers for Alzheimer's disease or other dementias before mild cognitive impairment appears.

Investigating balance-related gait patterns and their relationship with maximum torques generated by the hamstrings and quadriceps in older adults - Results from the Baltimore longitudinal study of aging

BackgroundBalance-related gait patterns in older adults can be objectively discerned through the examination of gait parameters, maximum leg torques, and their interconnections. ObjectiveTo investigate the correlation between leg muscle strength and balance during gait concerning functional performance in healthy older adults. MethodsParticipants included 117 adults aged 60-95 years were recruited from the Baltimore Longitudinal Study of Aging (BLSA). They underwent evaluations of gait, balance, and maximum isometric leg torque (for both hamstrings and quadriceps). Analyses examined the association between leg torque and functional performance among those with higher and lower balances. ResultsIndividuals with lower balance (n = 43) were older, more prone to experiencing a fear of falling, and exhibited lower functional performance (gait speeds and Generalized Gait Stability Scores (GGSS), ps < 0.001) compared to their counterparts with higher balance (n = 74). At a usual walking pace, the GGSS showed a positive association with concentric Quadriceps Maximum Torque (QMT) in participants with lower balance (p = 0.013). Conversely, it displayed a positive association with eccentric QMT in those with higher balance (p = 0.014). At a fast walking pace, only individuals with higher balance demonstrated a positive muscle torque association with both gait speed and GGSS, encompassing concentric and eccentric actions in both the quadriceps and hamstrings (ps < 0.050). ConclusionEvaluating muscle strength capacity in both concentric and eccentric phases during dynamic high-effort events, along with investigating their associations with gait performance, can be beneficial for identifying subtle gait deficits. This comprehensive approach may assist in the early detection of gait deterioration among healthy older adults, given the intricate muscle activations involved in lower body functional performance.

Is an 8-Week Regimen of Nordic Walking Training Sufficient to Benefit Cognitive Performance in Healthy Older Adults? A Pilot Study.

Nordic walking requires the association of walking and coordination of limbs while orienteering in a natural environment. It has been shown to improve functional capacities more than normal walking. However, its cognitive benefits are less clear. The main hypothesis was that this training improves visuospatial capacities and inhibition functions. A total of 14 healthy older adults were included. The training was performed in three sessions of 75 min a week for 8 weeks. Pre-, intermediate, and post-tests were carried out. Cognitive functions including global cognition (MoCA), executive functions (Color-Word Stroop test), speed of information processing, switching capacities (Trail Making Test A and B), and visuospatial capacities (Rey Complex Figure Copy Task) were assessed. Motor functions including balance control (Unipedal Balance Test), functional mobility (Timed Up and Go), hamstring flexibility (Chair Sit and Reach test), and motor coordination (Four-Square Stepping Test) were evaluated. Physical function, including lower limb strength (Timed Sit-To-Stand) and cardiovascular capacities (Incremental Shuttle Walking Test), was measured. Cardiovascular capacity, strength of lower limbs, and motor coordination were positively affected by training. With respect to cognition, training improved visuospatial capacities, while switching capacities, information processing speed, and executive functions did not improve. A possible explanation is that they needed a longer program duration to show benefits. However, analyses of responders suggested that NW positively affected cognitive functioning in a subset of participants. Eight weeks of NW training produced physical, motor, and cognitive improvements. A longer training duration could be necessary to extend the benefits to executive functions in all participants.

Cross-sectional associations between 24-hour time-use composition, grey matter volume and cognitive function in healthy older adults

BackgroundIncreasing physical activity (PA) is an effective strategy to slow reductions in cortical volume and maintain cognitive function in older adulthood. However, PA does not exist in isolation, but coexists with sleep and sedentary behaviour to make up the 24-hour day. We investigated how the balance of all three behaviours (24-hour time-use composition) is associated with grey matter volume in healthy older adults, and whether grey matter volume influences the relationship between 24-hour time-use composition and cognitive function.MethodsThis cross-sectional study included 378 older adults (65.6 ± 3.0 years old, 123 male) from the ACTIVate study across two Australian sites (Adelaide and Newcastle). Time-use composition was captured using 7-day accelerometry, and T1-weighted magnetic resonance imaging was used to measure grey matter volume both globally and across regions of interest (ROI: frontal lobe, temporal lobe, hippocampi, and lateral ventricles). Pairwise correlations were used to explore univariate associations between time-use variables, grey matter volumes and cognitive outcomes. Compositional data analysis linear regression models were used to quantify associations between ROI volumes and time-use composition, and explore potential associations between the interaction between ROI volumes and time-use composition with cognitive outcomes.ResultsAfter adjusting for covariates (age, sex, education), there were no significant associations between time-use composition and any volumetric outcomes. There were significant interactions between time-use composition and frontal lobe volume for long-term memory (p = 0.018) and executive function (p = 0.018), and between time-use composition and total grey matter volume for executive function (p = 0.028). Spending more time in moderate-vigorous PA was associated with better long-term memory scores, but only for those with smaller frontal lobe volume (below the sample mean). Conversely, spending more time in sleep and less time in sedentary behaviour was associated with better executive function in those with smaller total grey matter volume.ConclusionsAlthough 24-hour time use was not associated with total or regional grey matter independently, total grey matter and frontal lobe grey matter volume moderated the relationship between time-use composition and several cognitive outcomes. Future studies should investigate these relationships longitudinally to assess whether changes in time-use composition correspond to changes in grey matter volume and cognition.

Gesture imitation performance in community-dwelling older people: assessment of a gesture imitation task in the screening and diagnosis of mild cognitive impairment and dementia.

Gesture imitation, a simple tool for assessing visuospatial/visuoconstructive functions, is reportedly useful for screening and diagnosing dementia. However, gesture imitation performance in healthy older adults is largely unknown, as are the factors associated with lower performance. To address these unknowns, we examined the gesture imitation performance of a large number of community-dwelling older adults aged ≥65 years in Arao City, Kumamoto Prefecture (southern Japan). The examiner presented the participants with eight gesture patterns and considered it a success if they could imitate them within 10 s. The success rate of each gesture imitation was calculated for three diagnostic groups: cognitively normal (CN) (n = 1184), mild cognitive impairment (MCI) (n = 237), and dementia (n = 47). Next, we reorganised the original gesture imitation battery by combining six selected gestures with the following scoring method: if the participants successfully imitated the gestures, immediately or within 5 s, two points were assigned. If they succeeded within 5-10 s, one point was assigned. The sensitivity and specificity of the battery were investigated to detect the dementia and MCI groups. Factors associated with gesture imitation battery scores were examined. Except one complex gesture, the success rate of imitation in the CN group was high, approximately 90%. The sensitivity and specificity of the gesture imitation battery for discriminating between the dementia and CN groups and between the MCI and CN groups were 70%/88%, and 45%/75%, respectively. Ageing, male sex, and a diagnosis of dementia or MCI were associated with lower scores on the gesture imitation battery. Gesture imitation tasks alone may not be sufficient to detect MCI. However, by combining gestures with set time limits, gesture imitation tasks can be a low-burden and effective method for detecting dementia, even in community medicine, such as during health check-ups.

Impact of APOE-ε alleles on brain structure and cognitive function in healthy older adults: A VBM and DTI replication study.

The Apolipoprotein E (APOE) gene has been established in the Alzheimer's disease (AD) literature to impact brain structure and function and may also show congruent effects in healthy older adults, although findings in this population are much less consistent. The current study aimed to replicate and expand the multimodal approach employed by Honea et al. Structural magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), and neuropsychological measures were used to investigate the impact of APOE-ε status on grey matter structure, white matter integrity, and cognitive functioning. Data were obtained from the Alzheimer's Disease Initiative Phase 3 (ADNI3) database. Baseline MRI, DTI and cognitive composite scores for memory (ADNI-Mem) and executive function (ADNI-EF) were acquired from 116 healthy controls. Participants were grouped according to APOE allele presence (APOE-ε2+ N = 17, APOE-ε3ε3 N = 64, APOE-ε4+ N = 35). Voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) were used to compare grey matter volume (GMV) and white matter integrity, respectively, between APOE-ε2+ and APOE-ε3ε3 controls, and again between APOE-ε4+ and APOE-ε3ε3 controls. Multivariate analysis of covariance (MANCOVA) was used to examine the effects of APOE polymorphism on memory and EF across all APOE groups with age, sex and education as regressors of no interest. Cognitive scores were correlated (Pearson r) with imaging metrics within groups. No significant differences were seen across groups, within groups in MRI metrics, or cognitive performance (p>0.05, corrected for multiple comparisons). The current study partially replicated and extended previous findings from an earlier multimodal study (Honea 2009). Future studies should clarify APOE mechanisms in healthy ageing by adding other imaging, cognitive, and lifestyle metrics and longitudinal design in larger sample sizes.

A unique neuropsychophysiological approach to objectify emotion (dys)regulation in healthy older adults during the COVID-19 pandemic

The response of older people to the COVID-19 pandemic has attracted much attention as they are at increased risk of adverse outcomes. A longitudinal study has shown that improvement in global cognitive, executive and language functioning in healthy older adults enrolled at the University of the Third Age appears to play a protective role against emotional dysregulation and mood changes during the pandemic. To date, no study has examined emotional dysregulation through COVID-19-related images using facial electromyographic recordings in healthy older adults. Therefore, we aimed to analyze the relationships between zygomaticus and corrugator reactivity, neuropsychological measures, and the affective dimensions of arousal, dominance, and valence. The results showed an unexpected association between higher zygomaticus activity and higher levels of apathy, depression, and anxiety. In contrast, increased contracture of the corrugator was associated with poorer performance on cognitive tests (global cognition, memory, executive functions) and physical status, i.e., walking speed. These results are consistent with the reappraisal of emotional stimuli in response to the challenges of the pandemic. Interestingly, COVID-19-related stimuli triggered the activation of bottom-up affectivity strategies associated with higher mood levels and interacted with top-down factors that play an important role in the dysregulation of cognitive control.

OUT-OF-HOME MOBILITY, DAILY WORKING MEMORY, AND NEIGHBORHOOD WALKABILITY IN HEALTHY OLDER ADULTS

Abstract Out-of-home mobility could enhance cognitive performance, but environmental contexts — such as neighborhood walkability — may influence the associations. This study examined daily out-of-home mobility in relation to daily cognitive performance in healthy older adults and the moderator effects of neighborhood walkability therein. Participants wore a custom-built mobile GPS sensor („uTrail“) and completed smartphone-based working memory assessments for 15 days, and responded to the baseline Neighborhood Environment Walkability Scale. Analyses included 947 days’ data from 109 Swiss older adults aged 65 to 89 years. Out-of-home mobility (i.e., out-of-home time, maximum distance from home) were extracted from the GPS data. Multilevel models showed that daily out-of-home time and daily maximum distance from home were not associated with daily working memory performance across the study sample, but the associations were moderated by neighborhood walkability. Out-of-home time and maximum distance from home were positively (vs. negatively) associated with working memory performance in participants who lived in neighborhood with higher (vs. lower) street connectivity and more (vs. less) access to places for walking and cycling. Additionally, maximum distance from home were positively (vs. negatively) associated with working memory performance in participants in neighborhood with lower (vs. higher) mixture of land use. To conclude, spending more time out of home and travelling longer distance away from home could be beneficial for daily cognitive performance of older adults who lived in well-connected and higher-walkable and -bikeable neighborhood. Travelling longer distance could also benefit those who lived in a neighborhood with a lower mixture of land use.

Longitudinal Sleep Patterns and Cognitive Impairment in Older Adults

Sleep disturbances and clinical sleep disorders are associated with all-cause dementia and neurodegenerative conditions, but it remains unclear how longitudinal changes in sleep impact the incidence of cognitive impairment. To evaluate the association of longitudinal sleep patterns with age-related changes in cognitive function in healthy older adults. This cross-sectional study is a retrospective longitudinal analyses of the Seattle Longitudinal Study (SLS), which evaluated self-reported sleep duration (1993-2012) and cognitive performance (1997-2020) in older adults. Participants within the SLS were enrolled as part of a community-based cohort from the Group Health Cooperative of Puget Sound and Health Maintenance Organization of Washington between 1956 and 2020. Data analysis was performed from September 2020 to May 2023. The main outcome for this study was cognitive impairment, as defined by subthreshold performance on both the Mini-Mental State Examination and the Mattis Dementia Rating Scale. Sleep duration was defined by self-report of median nightly sleep duration over the last week and was assessed longitudinally over multiple time points. Median sleep duration, sleep phenotype (short sleep, median ≤7 hours; medium sleep, median = 7 hour; long sleep, median ≥7 hours), change in sleep duration (slope), and variability in sleep duration (SD of median sleep duration, or sleep variability) were evaluated. Of the participants enrolled in SLS, only 1104 participants who were administered both the Health Behavior Questionnaire and the neuropsychologic battery were included for analysis in this study. A total of 826 individuals (mean [SD] age, 76.3 [11.8] years; 468 women [56.7%]; 217 apolipoprotein E ε4 allele carriers [26.3%]) had complete demographic information and were included in the study. Analysis using a Cox proportional hazard regression model (concordance, 0.76) showed that status as a short sleeper (hazard ratio, 3.67; 95% CI, 1.59-8.50) and higher sleep variability (hazard ratio, 3.06; 95% CI, 1.14-5.49) were significantly associated with the incidence of cognitive impairment. In this community-based longitudinal study of the association between sleep patterns and cognitive performance, the short sleep phenotype was significantly associated with impaired cognitive performance. Furthermore, high sleep variability in longitudinal sleep duration was significantly associated with the incidence of cognitive impairment, highlighting the possibility that instability in sleep duration over long periods of time may impact cognitive decline in older adults.

Effects of mindfulness training and exercise on cognitive function in healthy older adults without dementia: the MEDEX clinical trial

AbstractBackgroundA 2×2 factorial multi‐site randomized clinical trial was conducted to determine whether Mindfulness Based Stress Reduction (MBSR), exercise, or their combination improve cognitive function in older adults..Method585 older adults (aged 65‐84; mean age 71.5, 72.5% women) with subjective cognitive concerns but no dementia were randomized to MBSR, exercise with aerobic, strength and functional components, combined MBSR and exercise, or a health education control group. Interventions lasted 18 months and consisted of group‐based classes and home practice.ResultNeither MBSR, exercise, nor their combination significantly improved either primary outcome of memory or cognitive control (composites of neuropsychological tests), or secondary outcomes of hippocampal volume, DLPFC thickness and surface area, functional cognitive capacity or self‐reported cognitive concerns.ConclusionAmong older adults with subjective cognitive concerns but without dementia, mindfulness training, exercise, or both did not significantly improve cognitive or brain structural outcomes.

Stereotype threat in telephone‐administered neuropsychological assessment in older Veterans with and without cognitive impairment

AbstractBackgroundNeuropsychological evaluation is ubiquitous in Alzheimer’s disease clinical care and research—from diagnosing cognitive deficits to evaluating treatment and outcomes. However, performance during evaluation can depend on factors other than one’s cognition, including stereotype threat. Stereotype threat occurs when people feel at risk of conforming to stereotypes about their social group, in this case, memory declines associated with aging. While stereotype threat in neuropsychological evaluation in healthy older adults has been established, we tested, for the first time, this construct in older adults with cognitive impairment.MethodTwenty older adults (range 63 – 89; mean age = 77.2, SD = 6.8) recruited from the Veteran’s Affairs Boston Healthcare system were administered a telephone Repeatable Battery of Neuropsychological Assessment (RBANS). Following baseline assessment, one‐week later participants received a stereotype threat condition prior to neuropsychological evaluation. Participants also received a reduced threat condition which de‐emphasized memory diagnosis (during a separate week, counterbalanced with the threat condition). In the fourth week and final session, supplemental measures were administered, including a telephone‐MoCA, demographics, and surveys measuring mood, dementia worry, beliefs about aging, and subjective memory complaints. Planned analyses include a mixed‐effects analysis of variance, with group (healthy; cognitively impaired) and condition (stereotype‐threat; threat‐reduced).ResultsOlder adults with cognitive impairment demonstrated lower performance across all domains of the RBANS, including list learning, story recall, fluency, digit span, delayed recall, and recognition, ηp 2 = .87‐.99. Older adults with impairment scored numerically lower but not statistically lower in list learning under stereotype threat (M = 17.4; SD = 6.6) compared to the reduced threat condition (M = 19.9; SD = 7.2). Confirmation of the analyses, including examination of covariates, will follow final subject recruitment (N = 28).ConclusionWe found that stereotype threat did not significantly impact performance of healthy older adults and older adults with cognitive impairment. We note that small, numerical differences emerged for list learning. Differences of just one point in neuropsychological evaluation can be impactful, especially with respect to norms and cutoff scores. As such, the results carry implications for neuropsychological evaluation in clinic practice and research broadly.

Older adults exhibit declines in instrumental activities of daily living during a virtual grocery shopping task

Introduction: The successful performance of instrumental activities of daily living (IADLs) is critical in maintaining independence for older adults. Traditional IADL questionnaires and performance-based assessments are time consuming, potentially unreliable, and fail to adequately consider the interplay between cognitive and motor performance in completing IADLs. The Cleveland Clinic Virtual Reality Shopping (CC-VRS) platform was developed to objectively quantify IADL performance through the characterization of cognitive, motor, and cognitive-motor function. The CC-VRS combines an immersive virtual grocery store with an omnidirectional treadmill to create a scenario in which the user physically navigates through a virtual environment. The primary aim of this project was to determine the known-group validity of the CC-VRS platform to characterize IADL performance in healthy older adults and young adults.Methods: Twenty healthy young (n = 10) and older (n = 10) adults completed the Basic and Complex CC-VRS scenarios. Position data from VR trackers on the hands, waist, and feet were used to quantify motor performance. Cognitive and dual-task performance were automatically calculated by the application during specific shopping sub-tasks.Results: Older adults exhibited significantly worse performance on multiple cognitive, motor, and dual-task outcomes of the CC-VRS (e. g., average walking speed, number of list activations, and stopping frequency).Discussion: The CC-VRS successfully discriminated IADL performance between young and healthy older adults. The complex realistic environment of the CC-VRS, combined with simultaneous evaluation of motor and cognitive performance, has the potential to more accurately characterize IADL performance by identifying subtle functional deficits that may precede neurological disease.

The Relationship between Physical Fitness and Cognitive Functions in Older People: A Systematic Review

The ageing process is associated with vulnerabilities, such as cognitive decline. Physical activity and exercise are key for preserving cognitive health in older age. This systematic review aims to analyse the effects of physical fitness programs on healthy older adults’ cognitive functions. An electronic search was performed in the PubMed, Web of Science, and Scopus databases. It included observational and experimental studies published between February 2017 and March 2023. Of the 1922 studies identified, 38 met the inclusion criteria. The findings show the positive effects of physical training on cognitive function in older adults. The most examined cognitive domains were executive function, memory function, and global cognition. Aerobic training prevailed, followed by resistance strength training and exergames. There was high variability in the characteristics of the protocols. The average length of interventions was 3–6 months; the frequency varied in the range of 1–4-times a week and 30–90 min sessions. The findings of this systematic review emphasise that physical fitness programs positively improve the specific domains of cognitive function in healthy older adults. These results can contribute to planning future interventions to improve the mental health of the older population and strengthen the development of policies for healthy ageing.

Older Adults: Comparing Traditional Exercise to an Interactive Technology Training

Aims This study compared the effect of traditional exercise training and game-based exercise by TRAZER© on dynamic balance activities, vestibular ocular motor sensory (VOMS), falls efficacy scale-international (FES-I), and muscular performance in healthy older adults. Methods Twenty-two older adults (mean age: 77.59 ± 6.20 years) randomly divided into two groups (1) exercise training (ET) and (2) ET + TRAZER©. Both groups participated in one-hour exercise sessions, three days a week for 10 wk. The ET + TRAZER© group completed the three dynamic/agility balance assessments each day. Results The results showed the three TRAZER© assessments significantly increased in the ET + TRAZER© group. However, there was not a statistically significant difference between the groups for timed up and go (TUG), sit-to-stand (STS), and FES-I. Conclusions Our findings provided evidence that game-based exercise intervention improved muscular function and VOMS, especially dynamic balance and reaction time in older adults.

Agility training to integratively promote neuromuscular, cardiorespiratory and cognitive function in healthy older adults: a one-year randomized-controlled trial

BackgroundExercise training recommendations for seniors include the targeted training of strength, balance, endurance and flexibility domains. Agility training (AT) is conceptualized as a multi-component and time-efficient training framework for older adults to improve physical, functional and cognitive health domains that are relevant for maintaining activities of daily living. The aim of this one-year trial was to comparatively evaluate the effects of agility training on physical and cognitive function.MethodsSeventy-nine healthy older adults (AT: 61.5% female, 70.8 ± 4.8 years, 27.7 ± 4.2 kg/m2; CG: 60.5% female, 69.6 ± 4.7 years, 27.5 ± 4.4 kg/m2) took part in this one-year randomized controlled intervention and were either assigned to the agility training group (AT) with two weekly 60 min AT sessions or to the control group (CG), receiving no treatment. Participants were assessed pre, intermediate and post intervention for strength and power, balance, gait speed under multi-task conditions, aerobic capacity as well as cognitive performance. Linear mixed effects models were used to analyze the effect of treatment over time.ResultsFifty-four participants (AG: 25, CG: 29) were analyzed, most drop-outs attributed to COVID-19 (17/30 dropouts). Adherence was good (75%) of 90 offered sessions. Notable effects in favor of AT were found for gait parameters in single (d = 0.355, Δ = 4.3%), dual (d = 0.375, Δ = 6.1%) and triple (d = 0.376, Δ = 6.4%) task conditions, counter movement jump performance (strength and power) (d = 0.203, Δ = 6.9%), static one leg balance (d = 0.256, Δ = 12.33%) and n-back reaction time (cognitive performance) (d = 0.204, Δ = 3.8%). No effects were found for the remaining outcomes (d < 0.175).ConclusionAT might serve as an integrative training approach for older adults particularly improving gait and lower limb power parameters. It seems suitable to improve a broad range of seniors’ health domains and should replace isolated training of these domains. However, individual variation and progression of exercises should be considered when programming agility training providing adequate challenges throughout a long-term intervention for all participants.Trial registrationDRKS, DRKS00017469. Registered 19 June 2019—Retrospectively registered.

4 Impact of APOE-ε Alleles on Brain Structure and Function in Healthy Older Adults: A VBM and DTI Replication Study

Objective:The Apolipoprotein E (APOE) gene has been established in the Alzheimer’s disease (AD) literature to impact brain structure and function and may also show congruent effects in healthy older adults, although findings in this population are much less consistent. Magnetic Resonance Imaging (MRI), Diffusion Tensor Imaging (DTI), and neuropsychological measures present as useful, non-invasive tools to investigate the impact of APOE-e allele status on grey matter structure, white matter integrity, and cognitive functioning, respectively. Nonetheless, studies to date have revealed mix findings and few studies have taken a multimodal approach to investigating APOE’s effects. Thus, the objective of the current study was to replicate and expand upon the multimodal neuroimaging study conducted by Honea et al. (2009), that examined the impact of APOE-e4 presence on brain structure and cognitive function in healthy older adults, with the addition of APOE-e2 carriers and cognitive composite measures. The aim of the current replication study was to identify reliable changes to grey matter volume and white matter integrity in healthy older adults as it relates to APOE-e allele presence and cognitive performance. This represents one of the first studies to investigate both the risk and protective effects of APOE-e alleles (e4 and e2 respectively) on measures of cognitive performance, GMV and white matter integrity in healthy older adults.Participants and Methods:Data were obtained from the Alzheimer’s Disease Initiative phase 3 (ADNI3) database. Baseline MRI, DTI and cognitive composite scores for memory (ADNI-Mem) and executive function (ADNI-EF) were acquired from 116 healthy controls. Participants were grouped according to APOE allele presence (APOE-e2+ N= 17, APOE-e3e3 N= 64, APOE-e4+ N=35). Voxel-based morphometry (VBM) and tract based spatial statistics (TBSS) were used to compare grey matter volume (GMV) and white matter integrity respectively between APOE-e2+ and APOE-e3e3 controls, and again between APOE-e4+ and APOE-e3e3 controls. Multivariate analysis of covariance (MANCOVA) was used to examine the effects of APOE polymorphism on memory and EF across all APOE groups with covariates of age, sex, education, and cognitive scores were correlated with imaging metrics within groups (Pearson r) to examine associations between cognitive performance and brain structure.Results:Consistent with findings from Honea et al. (2009), no significant differences were seen across APOE groups, within-groups in MRI metrics, or cognitive performance (p&gt;0.05, corrected for multiple comparisons). Taking a similar approach to Honea and company, nonsignificant, trend-level results were examined (p&lt;0.2, corrected for multiple comparisons) and suggested: 1) Decreased GMV and increased mean diffusivity (MD) were present in APOE-e4+ compared to APOE-e3e3 and 2) Increased GMV and fractional anisotropy (FA) were present in APOE-e2+ compared to APOE-e3e3.Conclusions:The current study replicated and extended previous findings. Trend-level findings across both the current and replicated study suggests there may be subtle neurostructural differences in healthy aging as a function of APOE-e4 status. The current study additionally found potential subtle differences in GMV and white matter integrity in APOE-e2 carriers at the trend-level, consistent with previous reports of APOE-e2 's protective effects against neurodegeneration. Although these findings should be interpreted with caution, trend-level effects seen in the current study are consistent with previous research and may hold important implications for APOE neuromechanisms.

2 Higher White Matter Hyperintensity Load Adversely Affects Pre-Post Proximal Cognitive Training Performance in Healthy Older Adults

Objective:Cognitive training has shown promise for improving cognition in older adults. Aging involves a variety of neuroanatomical changes that may affect response to cognitive training. White matter hyperintensities (WMH) are one common age-related brain change, as evidenced by T2-weighted and Fluid Attenuated Inversion Recovery (FLAIR) MRI. WMH are associated with older age, suggestive of cerebral small vessel disease, and reflect decreased white matter integrity. Higher WMH load associates with reduced threshold for clinical expression of cognitive impairment and dementia. The effects of WMH on response to cognitive training interventions are relatively unknown. The current study assessed (a) proximal cognitive training performance following a 3-month randomized control trial and (b) the contribution of baseline whole-brain WMH load, defined as total lesion volume (TLV), on pre-post proximal training change.Participants and Methods:Sixty-two healthy older adults ages 65-84 completed either adaptive cognitive training (CT; n=31) or educational training control (ET; n=31) interventions. Participants assigned to CT completed 20 hours of attention/processing speed training and 20 hours of working memory training delivered through commercially-available Posit Science BrainHQ. ET participants completed 40 hours of educational videos. All participants also underwent sham or active transcranial direct current stimulation (tDCS) as an adjunctive intervention, although not a variable of interest in the current study. Multimodal MRI scans were acquired during the baseline visit. T1- and T2-weighted FLAIR images were processed using the Lesion Segmentation Tool (LST) for SPM12. The Lesion Prediction Algorithm of LST automatically segmented brain tissue and calculated lesion maps. A lesion threshold of 0.30 was applied to calculate TLV. A log transformation was applied to TLV to normalize the distribution of WMH. Repeated-measures analysis of covariance (RM-ANCOVA) assessed pre/post change in proximal composite (Total Training Composite) and sub-composite (Processing Speed Training Composite, Working Memory Training Composite) measures in the CT group compared to their ET counterparts, controlling for age, sex, years of education and tDCS group. Linear regression assessed the effect of TLV on post-intervention proximal composite and sub-composite, controlling for baseline performance, intervention assignment, age, sex, years of education, multisite scanner differences, estimated total intracranial volume, and binarized cardiovascular disease risk.Results:RM-ANCOVA revealed two-way group*time interactions such that those assigned cognitive training demonstrated greater improvement on proximal composite (Total Training Composite) and sub-composite (Processing Speed Training Composite, Working Memory Training Composite) measures compared to their ET counterparts. Multiple linear regression showed higher baseline TLV associated with lower pre-post change on Processing Speed Training sub-composite (ß = -0.19, p = 0.04) but not other composite measures.Conclusions:These findings demonstrate the utility of cognitive training for improving postintervention proximal performance in older adults. Additionally, pre-post proximal processing speed training change appear to be particularly sensitive to white matter hyperintensity load versus working memory training change. These data suggest that TLV may serve as an important factor for consideration when planning processing speed-based cognitive training interventions for remediation of cognitive decline in older adults.