Roberta Forte

Enhancing cognitive functioning in the elderly: multicomponent vs resistance training

Purpose The primary purpose of this study was to compare the effects of two different exercise training programs on executive cognitive functions and functional mobility in older adults. A secondary purpose was to explore the potential mediators of training effects on executive function and functional mobility with particular reference to physical fitness gains. Methods A sample of 42 healthy community dwelling adults aged 65 to 75 years participated twice weekly for 3 months in either: (1) multicomponent training, prioritizing neuromuscular coordination, balance, agility, and cognitive executive control; or (2) progressive resistance training for strength conditioning. Participants were tested at baseline (T1), following a 4-week control period (T2), and finally at postintervention (T3) for executive function (inhibition and cognitive flexibility) and functional mobility (maximal walking speed with and without additional task requirements). Cardiorespiratory and muscular fitness were also assessed as potential mediators. Results Indices of inhibition, the functions involved in the deliberate withholding of prepotent or automatic responses, and measures of functional mobility improved after the intervention, independent of training type. Mediation analysis suggested that different mechanisms underlie the effects of multicomponent and progressive resistance training. While multicomponent training seemed to directly affect inhibitory capacity, resistance training seemed to affect it indirectly through gains in muscular strength. Physical fitness and executive function variables did not mediate functional mobility changes. Conclusion These results confirm that physical training benefits executive function and suggest that different training types might lead to such benefits through different pathways. Both types of training also promoted functional mobility in older adulthood; however, neither inhibitory capacity, nor muscular strength gains seemed to explain functional mobility outcomes.

Cognitively challenging physical activity benefits executive function in overweight children

Abstract This study tested the association between aerobic fitness and executive function and the impact of enhanced, cognitively challenging physical activity on executive function in overweight and lean children. Seventy children aged 9–10 years were assigned to either a 6-month enhanced physical education programme including cognitively demanding (open skill) activities or curricular physical education only. Pre- and post-intervention tests assessed aerobic capacity (Leger test) and two components of executive function: inhibition and working memory updating (random number generation task). Indices of inhibition and memory updating were compared in higher- and lower-fit children and intervention effects were evaluated as a function of physical activity programme (enhanced vs. curricular) and weight status (lean vs. overweight). Results showed better inhibition in higher- than lower-fit children, extending the existing evidence of the association between aerobic fitness and executive function to new aspects of children’s inhibitory ability. Overweight children had more pronounced pre- to post-intervention improvements in inhibition than lean children only if involved in enhanced physical education. Such intervention effects were not mediated by aerobic fitness gains. Therefore, the cognitive and social interaction challenges inherent in open skill tasks, even though embedded in a low-dose physical activity programme, may represent an effective means to promote cognitive efficiency, especially in overweight children.

Effects of age and limb dominance on upper and lower limb muscle function in healthy males and females aged 40–80 years

Abstract This study investigated the effects of gender, age, and dominance on upper and lower limb muscle function. One hundred and fifty-two males and females aged 20–30 and 40–80 years were recruited. Maximal voluntary isometric strength (MVC) and rate of force development (RFD) of the knee extensor muscles, and handgrip MVC were measured bilaterally as indicators of lower and upper limb muscle function, respectively. In both sexes, significant main effects were found for age (knee extension MVC, RFD, and handgrip MVC) and limb dominance (handgrip MVC). Men exhibited a steeper age-related decline in muscle function than women, particularly in the lower limb [dominant limb: knee extension MVC −56% (men) vs. −35% (women); handgrip MVC −30% (men) vs. −26% (women); RFD −67% (men) vs. −47% (women); non-dominant limb: knee extension MVC −49% (men) vs. −36% (women); handgrip MVC −26% (men) vs. −24% (women); RFD −62% (men) vs. −44% (women)]. Although men showed a higher rate of decline in muscle function, in absolute terms they demonstrated better muscle function than women in all age groups, which has important implications for independence and quality of life. A clear asymmetry in muscle function was evident in both sexes only for handgrip MVC.

Acute and Chronic Exercise Effects on Attentional Control in Older Road Cyclists

Background: Research on visual attention control of older road cyclists, who represent a subgroup of traffic participants, is still scarce and studies on their attentional performance while cycling are completely lacking. Objective: The present study assessed whether attention control performance of older individuals with a history of participation in road cycling is affected by concomitant cycling exercise. Acute exercise effects were also analyzed in co-aged aerobically trained and sedentary noncyclists to assess whether the acute exercise-cognition relationship is moderated by individual differences induced by chronic sport practice versus sedentary lifestyle. Methods: Sixteen 60- to 80-year-old cyclists and 32 age-matched noncyclists (16 endurance athletes and 16 sedentary individuals) performed a go/no-go reaction time task in which visual attention was cued by means of spatial cues of different sizes followed by compound stimuli with local and global target features. Results: Older cyclists showed commonalities with and differences from other aerobically trained athletes. Both trained groups, when compared to sedentary individuals, showed shorter reaction time (RT) during physical exercise and a smaller RT disadvantage for unexpected local targets at short stimulus-onset asynchrony (SOA). This expectancy-driven RT effect was stable across SOAs only in the case of cyclists. Conclusions: Results suggest that chronic long-term aerobic training may lead to favorable conditions for the occurrence of a facilitation effect during acute exercise and for a more efficient use of available resources on attentional tasks involving executive control. These results highlight the importance of considering the effects of aerobic exercise for supporting safe on-road behavior.

Intra- and inter-session reliability of vertical jump performance in healthy middle-aged and older men and women

Abstract Despite its widespread use in performance assessment, the reliability of vertical jump in an ageing population has not been addressed properly. The aim of the present study was to assess intra- and inter-day reliability of countermovement jump in healthy middle-aged (55–65 years) and older (66–75 years) men and women. Eighty-two participants were recruited and asked to perform countermovement jumps on two different occasions interspersed by 4 weeks. The middle-aged groups exhibited excellent absolute reliability for flight height, jump height, peak force, peak power, peak force/body mass, and peak power/body mass, with coefficients of variation ranging from 2.9% to 7.2% in men and from 3.6% to 6.9% in women and moderate-to-high intraclass correlations (0.75 to 0.97 in men; 0.77 to 0.95 in women). The older groups displayed good coefficients of variation (4.2% to 10.8% in men and 3.4% to 9.5% in women), but the intraclass correlations were low-to-high (0.43 to 0.84 in men; 0.42 to 0.93 in women). Overall, intra-session reliability was higher than inter-session reliability. Peak power was by far the most consistent variable, whereas flight and jump height had the most marked variability. The minimum detectable change varied from 10.5% to 33%, depending on the variable examined, suggesting important implications for intervention studies.

Relationship between performance-based and laboratory tests for lower-limb muscle strength and power assessment in healthy older women

Abstract The aim of the study was to assess the relationship between performance-based and laboratory tests for muscular strength and power assessment in older women. Thirty-two women aged 68.8 ± 2.8 years were recruited. All participants were asessed for: (a) two performance-based tests – the box-stepping test (mean 296 ± 51 J) and two-revolution maximum test (mean 7.1 ± 2 kg) performed while pedalling on a cycle ergometer; and (b) muscular function tests – maximal instantaneous peak power jumping on a force platform (mean 1528 ± 279 W); maximal voluntary contraction (MVC) during knee extension (mean 601 ± 571 N) and leg press (mean 626 ± 126 N), and leg press power (mean 483 ± 98 W) on a dynamometer. Using univariate analysis, performance-based tests were compared with laboratory muscle strength and power measurements. Muscle power correlated most strongly with the performance-based tests for both jumping and leg press power (r-values between 0.67 and 0.75; P < 0.01). The correlation with muscle strength measures ranged between 0.48 and 0.61 (P < 0.01). The proposed tests may have particular relevance in geriatric and rehabilitation environments as they represent an easy, practical, and inexpensive alternative for the assessment of muscular strength and power.

Health and Quality of Life Perception in Older Adults: The Joint Role of Cognitive Efficiency and Functional Mobility

Cognitive and mobility functions are involved in health-related quality of life (HRQoL). The present cross-sectional study aimed at investigating what facets of efficient cognition and functional mobility interactively contribute to mental and physical HRQoL. Fifty-six healthy older individuals (aged 65–75 years) were evaluated for mental and physical HRQoL, core cognitive executive functions (inhibition, working memory, and cognitive flexibility), and functional mobility (walking) under single and dual task conditions. Multiple regression analyses were run to verify which core executive functions predicted mental and physical HRQoL and whether the ability to perform complex (dual) walking tasks moderated such association. Inhibitory efficiency and the ability to perform physical-mental dual tasks interactively predicted mental HRQoL, whereas cognitive flexibility and the ability to perform physical dual tasks interactively predicted physical HRQoL. Different core executive functions seem relevant for mental and physical HRQoL. Executive function efficiency seems to translate into HRQoL perception when coupled with tangible experience of the ability to walk under dual task conditions that mirror everyday life demands. Implications of these results for supporting the perception of mental and physical quality of life at advanced age are discussed, suggesting the usefulness of multicomponent interventions and environments conducive to walking that jointly aid successful cognitive aging and functional mobility.

Executive function moderates the role of muscular fitness in determining functional mobility in older adults

Background and aimsBoth physical and cognitive factors are known to independently predict functional mobility in older people. However, the combined predictive value of both physical fitness and cognitive factors on functional mobility has been less investigated. The aim of the present study was to assess if cognitive executive functions moderate the role of physical fitness in determining functional mobility of older individuals.MethodsFifty-seven 65- to 75-year-old healthy participants performed tests of functional mobility (habitual and maximal walking speed, maximal walking speed while picking up objects/stepping over obstacles), physical fitness (peak power, knee extensors torque, back/lower limb flexibility, aerobic fitness), and executive function (inhibition and cognitive flexibility).ResultsMaximal walking speeds were predicted by physical fitness parameters and their interaction with cognitive factors. Knee extensor torque emerged as the main predictor of all tested locomotor performances at maximal speed. The effect of peak power and back/lower limb flexibility was moderated by executive functions. In particular, inhibition and cognitive flexibility differed in the way in which they moderate the role of fitness. High levels of cognitive flexibility seem necessary to take advantage of leg power for walking at maximal speed. In contrast, high levels of inhibitory capacity seem to compensate for low levels of back/lower limb flexibility when picking up movements are added to a locomotor task.ConclusionsThese findings may have important practical implications for the design and implementation of multi-component training programs aimed at optimizing functional abilities in older adults.

Comparison of the effect of multicomponent and resistance training programs on metabolic health parameters in the elderly.

UNLABELLED Physical activity interventions such as resistance training (RT) and multicomponent (MCT) exercise training are known to improve functional mobility and reduce the risk of disability among the elderly. Less evidence exists regarding the effectiveness of such exercises to improve metabolic risk factors for age related conditions. This study aimed to compare the effects of MCT and RT programs on metabolic health parameters in healthy elderly. METHODS Twenty one and 18 subjects completed a 12-week MCT and RT program respectively. Before and after intervention, body composition, functional ability, aerobic fitness and metabolic health parameters including lipid profile, inflammatory markers, glucose metabolism, hormones and growth markers were examined. Circulating concentrations of epidermal growth factor increased significantly in the MCT group from 35.8 ± 29.4 to 56.1 ± 35 pg/ml. High molecular weight adiponectin decreased significantly in the RT group from 4.7 ± 2.9 to 4.2 ± 2.3 μg/ml (p=0.03). No other biochemical parameter was significantly altered within either group. A significant between group difference was found for both ferritin (p=0.02) and EGF (p=0.01), with concentrations of ferritin decreasing in the MCT group and increasing in the RT group and concentration of EGF increasing in the MCT group yet decreasing in the RT group. The MCT program improved results of functional tests including chair stand and habitual walking speed. Present findings suggest that although both the MCT and RT interventions were enough to produce functional and physical benefits, different training programs and/or exercise dose are required to improve metabolic health in healthy older adults.

The body fat-cognition relationship in healthy older individuals: Does gynoid vs android distribution matter?

ObjectiveTo examine the relationship between regional and whole body fat accumulation and core cognitive executive functions.DesignCross-sectional study.Settings and participants78 healthy men and women aged between 65 and 75 years recruited through consumer’s database.MeasurementsDXA measured percentage total body fat, android, gynoid distribution and android/gynoid ratio; inhibition and working memory updating through Random Number Generation test and cognitive flexibility by Trail Making test. First-order partial correlations between regional body fat and cognitive executive function were computed partialling out the effects of whole body fat. Moderation analysis was performed to verify the effect of gender on the body fat-cognition relationship.ResultsResults showed a differentiated pattern of fat-cognition relationship depending on fat localization and type of cognitive function. Statistically significant relationships were observed between working memory updating and: android fat (r = -0.232; p = 0.042), gynoid fat (r = 0.333; p = 0.003) and android/gynoid ratio (r = -0.272; p = 0.017). Separating genders, the only significant relationship was observed in females between working memory updating and gynoid fat (r = 0.280; p = 0.045). In spite of gender differences in both working memory updating and gynoid body fat levels, moderation analysis did not show an effect of gender on the relationship between gynoid fat and working memory updating.ConclusionsResults suggest a protective effect of gynoid body fat and a deleterious effect of android body fat. Although excessive body fat increases the risk of developing CDV, metabolic and cognitive problems, maintaining a certain proportion of gynoid fat may help prevent cognitive decline, particularly in older women. Guidelines for optimal body composition maintenance for the elderly should not target indiscriminate weight loss, but weight maintenance through body fat/lean mass control based on non-pharmacological tools such as physical exercise, known to have protective effects against CVD risk factors and age-related cognitive deterioration.