Guilherme Eustáquio Furtado

Strength Training Decreases Inflammation and Increases Cognition and Physical Fitness in Older Women with Cognitive Impairment

Introduction: Cognitive impairment that affects older adults is commonly associated with an inflammatory imbalance, resulting in decreased physical fitness. Exercise has been pointed to mitigate immunosenescence and cognitive impairment associated with aging, while increase in physical fitness. However, few studies explored the relationship between changes in cytokine concentration and improvement on cognition due to elastic band strength training. The aim of this study was to investigate the effects of strength training on pro-and anti-inflammatory cytokines, hematological markers and physical fitness of older women with cognitive impairment. Methods: Thirty-three women (82.7 ± 5.7 years old) participated in the study and were divided in two groups: strength exercise training group (ST; n = 16) and Control Group (CG; n = 17) and were evaluated before and after 28 weeks of the exercise program. The CG did not undergo any type of exercise programs. Data for IL-10, TNF-α, IFN-γ, C-Reactive Protein (CRP), white blood counts (WBC), red blood counts (RBC), Mini Mental State Examination (MMSE) and physical fitness tests were analyzed in both moments. Results: IL-10 increased in the ST group without changes in CG. TNF-α and CRP increased in the control group while no changes were observed for IFN-γ in both groups. Strength training decreased leukocyte and lymphocyte counts and increase hemoglobin, mean cell volume and mean cell hemoglobin concentration. The MMSE score increased in strength training group but remained unchanged in the control group. A correlation between the variation of granulocyte counts and the MMSE scores was also observed within the total sample. An improvement in physical fitness was observed with strength training. Conclusion: Resistance exercise promoted better anti-inflammatory balance and physical performance simultaneously with an increase in cognitive profile in older women with cognitive impairment.

Study Protocol on Hormonal Mediation of Exercise on Cognition, Stress and Immunity (PRO-HMECSI): Effects of Different Exercise Programmes in Institutionalized Elders

Physical activity (PA) in elders has been shown to have positive effects on a plethora of chronic diseases and to improve immunity, mental health, and cognition. Chronic stress has also been shown to have immuno-suppressive effects and to accelerate immunosenescence. Exercise could be a significant factor in ameliorating the deleterious effects of chronic stress, but variables such as the type, intensity, and frequency of exercise that should be performed in order to effectively reduce the stress burden need to be defined clearly. PRO-HMECSI will allow us to investigate which hormonal and immunological parameters are able to mediate the effects of exercise on mucosal immunity, psychological/biological stress, and cognitive functioning in older people. Phase I consists of an observational cross-sectional study that compares elders groups (n = 223, >65 years) by functional fitness levels aiming to identify biomarkers involved in maintaining immune and mental health. Neuroendocrine and immune biomarkers of stress, psychological well-being related to mental health, neurocognitive function, functional fitness, and daily PA will be evaluated. Phase II consists of a 28-week intervention in elders with mild cognitive impairment (MCI) profile (n = 149, >65 years, divided in three groups of exercise and one control group), aiming to investigate whether the positive effect of three different types of chair-based exercise programs on physical and psychological health is mediated by an optimal endocrine environment. Primary outcomes are measures of cognitive function and global health. Secondary outcomes include the evaluation the other dimensions such as immune function, psychological health, and depression. Few studies addressed the effects of different types of exercise interventions in older population samples with MCI. We will also be able to determine which type of exercise is more effective in the immune and hormonal function of this population.

Physical Fitness and Frailty Syndrome in Institutionalized Older Women

Associations between frailty and physical-functional fitness (PFF) indicators in frail women over 65 years of age remain largely unexplored. This study analyzed the relationship between frailty syndrome (FS) and PFF indicators and assessed how the latter might predict the former. Participants were 119 elderly women (81.96 ± 7.89 years) recruited from four social and healthcare centers. PFF was assessed through muscle strength tests of upper and lower limbs, endurance, agility-dynamic balance, flexibility, and body composition. The following FS indicators were assessed: weight loss, exhaustion, weakness, slowness, and low physical activity level. Significant correlations were found between FS and endurance, agility-dynamic balance, upper and lower limbs muscle strength tests. Comparitive analyses also revealed that, among FS groups, the frail subgroup performed significantly poorer on all PFF measures except body composition. Additionally, a receiving operating characteristics curve analysis revealed good diagnostic accuracy for predicting FS using the agility-dynamic balance test (Area Under Curve [AUC] = .82, 95% CI [0.74, 0.90]; sensitivity and specificity were 70.4% and 84.8% for the cutoff = 16.22 seconds). Accurately, the risk of frail condition (not pre-frail) increases about 2.12% per second spent in this test. Thus, the agility-dynamic balance test is a promising tool for screening institutionalized older people for risk of FS.

Effects of a Physical Exercise Program (PEP-Aut) on Autistic Children’s Stereotyped Behavior, Metabolic and Physical Activity Profiles, Physical Fitness, and Health-Related Quality of Life: A Study Protocol

Physical exercise has shown positive effects on symptomatology and on the reduction of comorbidities in population with autism spectrum disorder (ASD). However, there is still no consensus about the most appropriate exercise intervention model for children with ASD. The physical exercise program for children with autism (PEP-Aut) protocol designed allow us to (i) examine the multivariate associations between ASD symptoms, metabolic profile, physical activity level, physical fitness, and health-related quality of life of children with ASD; (ii) assess the effects of a 40-week exercise program on all these aspects of children with ASD. The impact of the exercise program will be assessed based on the sequence of the two phases. Phase 1 is a 12-week cross-sectional study assessing the symptomatology, metabolic profile, physical fitness and physical activity levels, socioeconomic status profile, and health-related quality of life of participants. This phase is the baseline of the following phase. Phase 2 is a 48-week intervention study with a 40-week intervention with exercise that will take place in a specialized center for children with ASD in the city of Maceió-Alagoas, Brazil. The primary outcomes will be change in the symptomatic profile and the level of physical activity of children. Secondary outcomes will be anthropometric and metabolic profiles, aerobic function, grip strength, socioeconomic status, and health-related quality of life. The study will provide critical information on the efficacy of exercise for children with ASD and help guide design and delivery of future programs.

Physical frailty and cognitive status over-60 age populations: A systematic review with meta-analysis

The aim of this meta-analysis was to analyse the magnitude of the effect-size of the cognitive status of populations over 60 years of age, when comparing nonfrail versus pre-frail and nonfrail versus frail subgroups. A systematic review of prospective studies published from 2000 to 2017 was completed in Medline, B-on, Ebsco, Ebsco Health, Scielo, ERIC, LILACS and Sport discus databases and observational, cohort and cross-sectional studies were selected. The Mini-Mental State Examination to screening cognitive status and the Fried phenotype for assess physical frailty state was used as clinical outcomes. After applying additional search criteria, 14 manuscripts (26,798 old participants) were selected from an initial universe of 1681 identified. When comparing the scores of cognitive status of the participants who were non-frail (n = 12,729, 47.4%) versus pre-frail (n = 11,559, 43.2%) and non-frail versus frail (n = 2452, 9.4%) subgroups, significant statistical differences were found for both comparisons (M ± SD = 0.60, 95%CI: 0.50-0.62, p < 0.001 and M ± SD = 3.43, 95%CI: 2.26-4.60, p < 0.001, respectively). It is clear that poor cognitive function is strongly closed associated with pre-frailty and frailty subgroups in older populations around the world.

Exercise and taurine in inflammation, cognition, and peripheral markers of blood-brain barrier integrity in older women

Immunosenescence contribute to increase the blood-brain barrier (BBB) permeability, leading cognitive impairment and neurodegeneration. Thus, we investigated the anti-inflammatory effect of exercise and taurine supplementation on peripheral markers of BBB, inflammation, and cognition of elderly women. Forty-eight elderly women (age, 83.58 ± 6.9 years) participated in the study, and were allocated into combined exercise training (CET: n = 13), taurine supplementation (TAU: n = 12), exercise training associated with taurine (CET+TAU: n = 11), or control (CG: n = 12) groups. Exercise was applied twice a week (multi-modal exercise). Taurine ingestion was 1.5 g., once a day. Participants were evaluated before and after 14-weeks of intervention. Plasma levels of interleukin (IL)-1β, IL-1ra, IL-6, IL-10, IL-17, tumor necrosis factor alpha (TNF-α), and serum concentration of S100β and neuron specific enolase (NSE) were determined. The mini mental state examination (MMSE) was also applied. Concentrations of S100β were maintained in all intervention groups, while a subtle increase in the CG was found. NSE levels increased only in TAU group (p < 0.05). CET reduced TNF-α, IL-6, and IL-1β/IL-1ra, IL-6/IL10, and TNF-α/IL-10 ratios (p < 0.05). TAU decreased the IL-1β/IL-1ra ratio (p < 0.05). MMSE score increased only in the CET+TAU group (p < 0.05). Multiple regression analysis showed that there was a trend for changes in IL-1β and the Charlson Comorbidity Index to be independently associated with changes in S100β. Exercise and taurine decreased inflammation, and maintained the BBB integrity in elderly women. Exercise emerged as an important tool to improve brain health even when started at advanced ages.