January 1, 2008

Linking Cognitive Functioning and Exercise

Exercise has been suggested as an innovative approach to improving cognitive functioning in older adults. Photo courtesy of the USDA, ARS.Excercise directly affects the structure and function of the brain. Exercise has been suggested as an innovative approach to improving cognitive functioning in older adults. The benefits of exercise for general health and well-being in older adults are already well known. (Scandinavian Journal of Medicine & Science in Sports 2006, 16:3-63).

Cross-sectional evidence suggests that older adults who are physically active display better cognitive functioning than their sedentary peers, in areas such as memory, reaction time, and visuospatial skills.

Prospective and longitudinal findings suggest that physical inactivity is predictive of subsequent cognitive decline and that changes in physical activity patterns over time are associated with changes in cognitive functioning.

Experimental studies of exercise training programs for older adults have generally shown improvements in cognitive functioning, particularly on measures of information processing speed and executive functioning.

While some experimental studies have been less conclusive, this discrepancy is most likely attributable to methodological differences. These include differences in duration, intensity, and frequency of exercise training, along with differences in control groups, exclusion criteria, and cognitive outcome measures.

A meta-analysis by Colcombe and Kramer found that, overall, excercise interventions do have the potential to improve cognitive functioning in older adults, particularly mental speed and executive functioning. The meta-analysis also highlighted that the most beneficial programs are those which have exercise sessions of greater than 30 minutes duration, include aerobic and strength training components, and target adults aged between 65 and 70 years. (Psychological Science 2003, 14:125-130).

Linking exercise and cognitive functioning

Several mechanisms have been suggested to explain the relationship between exercise and cognitive functioning. The main hypothesis is that excercise directly affects the structure and function of the brain.

Increases in aerobic capacity (as a result of increases in exercise) are thought to increase cerebral blood flow, improve the transport and utilization of oxygen and glucose in the brain, promote neurogenesis (the creation of new nerve cells), and regulate neurotransmitter synthesis.

Psychological factors may play a role in mediating the relationship between exercise and cognition. Exercise is known to improve psychological well-being, and psychological well-being has been associated with cognitive functioning.

A few studies of exercise training and cognitive training have included psychological measures, but results have been mixed. More research is required to elucidate the mediating role of psychological factors in the exercise-cognition relationship.

Combination training for cognitive benefits.

Some researchers have suggested that the benefits of exercise may be further enhanced by combining exercise training with cognitive training.

Cognitive training has been the traditional approach to improving cognitive functioning in older adults. It consists of learning and practicing skills and techniques to manage cognitively demanding situations (e.g. using mnemonics to aid recall).

While these programs have been successful in improving the specific cognitive function targeted by the training (i.e. memory programs improve memory performance), they do not have the potential to provide the physical and cognitive benefits offered by exercise training. A combination of exercise training and cognitive training, however, may provide the best of both worlds.

Fabre and colleagues conducted an experimental study of combination training with four groups: aerobic training, cognitive training, aerobic and cognitive training, and control. They found that all three training groups improved significantly, with the combination training group (aerobic and cognitive training) improving significantly more than the other groups. (International Journal of Sports Medicine 2002, 23:415-421).

These findings are limited, however, by the fact that the combination training group appear to have received a greater total number of training sessions per week than the other groups. Given that engaged lifestyles have been linked to cognitive performance in older adults, it is possible that the results of the combination training group could be a consequence of increased social interaction, rather than an added benefit of cognitive training.

The potential of combined exercise and cognitive training could be better investigated by matching the overall training exposure of participants in a dual group [exercise training and cognitive training] to that of participants in an exercise training group.

With an increasingly aged population, interventions to improve the functioning and quality of life of older adults are particularly important. Exercise training, either alone or in combination with cognitive training, may be an effective means of optimizing cognitive functioning in older adults.

Extracted and adapted from: O'Dwyer ST, Burton NW, Pachana NA, Brown WJ. Protocol for Fit Bodies, Fine Minds: a randomized controlled trial on the affect of exercise and cognitive training on cognitive functioning in older adults. BMC Geriatrics 2007, 7:23 (4 October 2007). doi:10.1186/. © 2007 O'Dwyer et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0). Photo courtesy of the USDA, ARS

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