Promoting Cognitive Resilience through Exercise in Aging: Understanding the Mechanisms and Crafting Tailored Exercise Programs for Older Adults - A Critical Review
Exercise and Cognitive Resilience among Older Adults
Keywords:
Brain-Derived Neurotrophic Factor, Cognition, Exercise, Physical ActivityAbstract
The benefits of regular physical activity and exercise are increasingly seen as key to enhancing the brain health of the elderly. Despite this growing awareness, specific guidelines for physical activities designed to improve cognitive functions are yet to be established, and the precise mechanisms that underlie cognitive benefits from such stimulation remain unclear. This review will explore current studies on how exercise and physical activities impact cognitive abilities in individuals without cognitive deficits. We aim to pinpoint the reasons behind these benefits and offer recommendations for exercise routines that could improve cognitive functions. Attention is given to three main biological mechanisms believed to drive the cognitive improvements associated with exercise: promoting neuroplasticity and growth factors, reducing inflammation biomarkers, and regulating the hypothalamic-pituitary-adrenal axis. The concluding section details factors that enhance cognitive function in the elderly, such as the nature of exercise, its frequency and type, intensity and session length, and total workout duration.
References
Yoshino N, Kim CJ, Sirivunnabood P. Aging population and its impacts on fiscal sustainability. Ageing Societies. 2019 Mar 15.
Chiaranai C, Chularee S, Srithongluang S. Older people with chronic illness. Geriatric Nursing. 2018 Sep 1;39(5):513-20.
Cipriani G, Danti S, Picchi L, Nuti A, Fiorino MD. Daily functioning and dementia. Dementia & neuropsychologia. 2020 Jun 12;14:93-102.
Shirai K, Iso H. Dementia. Social Determinants of Health in Non-communicable Diseases: Case Studies from Japan. 2020:105-23.
Bivona G, Iemmolo M, Ghersi G. Cerebrospinal and Blood Biomarkers in Alzheimer's Disease: Did Mild Cognitive Impairment Definition Affect Their Clinical Usefulness? International Journal of Molecular Sciences. 2023 Nov 29;24(23):16908.
Alzheimer's Association. 2018 Alzheimer's disease facts and figures. Alzheimer's & Dementia. 2018 Mar 1;14(3):367-429.
Li J, Herold F, Ludyga S, Yu Q, Zhang X, Zou L. The acute effects of physical exercise breaks on cognitive function during prolonged sitting: The first quantitative evidence. Complementary Therapies in Clinical Practice. 2022 Aug 1;48:101594.
Harris TC, De Rooij R, Kuhl E. The shrinking brain: cerebral atrophy following traumatic brain injury. Annals of biomedical engineering. 2019 Sep 15;47:1941-59.
Chang YK, Nien YH, Tsai CL, Etnier JL. Physical activity and cognition in older adults: the potential of Tai Chi Chuan. J Aging Phys Act. 2010;18(4):451–472.
Walsh JN, Manor B, Hausdorff J, Novak V, Lipsitz L, Gow B, Macklin EA, Peng CK, Wayne PM. Impact of short-and long-term tai chi mind-body exercise training on cognitive function in healthy adults: results from a hybrid observational study and randomized trial. Global advances in health and medicine. 2015 Jul;4(4):38-48.
Qiu Y, Fernández-García B, Lehmann HI, Li G, Kroemer G, López-Otín C, Xiao J. Exercise sustains the hallmarks of health—Journal of sport and health science. 2023 Jan 1;12(1):8-35.
Yang GY, Sabag A, Hao WL, Zhang LN, Jia MX, Dai N, Zhang H, Ayati Z, Cheng YJ, Zhang CH, Zhang XW. Tai Chi for health and well-being: A bibliometric analysis of published clinical studies between 2010 and 2020. Complementary therapies in medicine. 2021 Aug 1;60:102748.
Uysal G, Ozturk M. Hippocampal atrophy based Alzheimer’s disease diagnosis via machine learning methods. Journal of Neuroscience Methods. 2020 May 1;337:108669.
Jaberi S, Fahnestock M. Mechanisms of the Beneficial Effects of Exercise on Brain-Derived Neurotrophic Factor Expression in Alzheimer’s Disease. Biomolecules. 2023 Oct 26;13(11):1577.
Zhou B, Wang Z, Zhu L, Huang G, Li B, Chen C, Huang J, Ma F, Liu TC. Effects of different physical activities on brain-derived neurotrophic factor: A systematic review and Bayesian network meta-analysis. Frontiers in Aging Neuroscience. 2022 Aug 26;14:981002.
Dinoff A, Herrmann N, Swardfager W, Liu CS, Sherman C, Chan S, Lanctot KL. The effect of exercise training on resting concentrations of peripheral brain-derived neurotrophic factor (BDNF): a meta-analysis. PloS one. 2016 Sep 22;11(9):e0163037.
Quigley A, MacKay-Lyons M, Eskes G. Effects of Exercise on cognitive performance in older adults: a narrative review of the evidence, possible biological mechanisms, and recommendations for exercise prescription. Journal of aging research. 2020 May 14, 2020.
Górna S, Domaszewska K. The effect of endurance training on serum BDNF levels in the chronic Post-Stroke Phase: Current evidence and qualitative systematic review. Journal of Clinical Medicine. 2022 Jun 20;11(12):3556.
Anderson-Hanley C, Barcelos NM, Zimmerman EA, Gillen RW, Dunnam M, Cohen BD, Yerokhin V, Miller KE, Hayes DJ, Arciero PJ, Maloney M. The aerobic and cognitive exercise study (ACES) for community-dwelling older adults with or at-risk for mild cognitive impairment (MCI): neuropsychological, neurobiological and neuroimaging outcomes of a randomized clinical trial. Frontiers in ageing neuroscience. 2018 May 4;10:76.
Liu Y, Yan T, Chu JM, Chen Y, Dunnett S, Ho YS, Wong GT, Chang RC. The beneficial effects of physical Exercise in the brain and related pathophysiological mechanisms in neurodegenerative diseases. Laboratory Investigation. 2019 Jul 1;99(7):943-57.
Harris TC, De Rooij R, Kuhl E. The shrinking brain: cerebral atrophy following traumatic brain injury. Annals of biomedical engineering. 2019 Sep 15;47:1941-59.
Teleanu DM, Niculescu AG, Lungu II, Radu CI, Vladâcenco O, Roza E, Costăchescu B, Grumezescu AM, Teleanu RI. An overview of oxidative stress, neuroinflammation, and neurodegenerative diseases. International journal of molecular sciences. 2022 May 25;23(11):5938.
Skaper SD, Facci L, Zusso M, Giusti P. An inflammation-centric view of neurological disease: beyond the neuron. Frontiers in cellular neuroscience. 2018 Mar 21;12:72.
Furman D, Campisi J, Verdin E, Carrera-Bastos P, Targ S, Franceschi C, Ferrucci L, Gilroy DW, Fasano A, Miller GW, Miller AH. Chronic inflammation in the aetiology of disease across the life span. Nature medicine. 2019 Dec;25(12):1822-32.
Bettcher BM, Wilheim R, Rigby T, Green R, Miller JW, Racine CA, Yaffe K, Miller BL, Kramer JH. C-reactive protein is related to memory and medial temporal brain volume in older adults—brain, behaviour, and immunity. 2012 Jan 1;26(1):103-8.
Boccardi V, Baroni M, Cecchetti R, Scamosci M, Bastiani P, Mecocci P. Serum interleukin-6 levels are higher in older subjects with Alzheimer's dementia. Geriatric Care. 2021 Feb 19;7(1).
Cronin O, Keohane DM, Molloy MG, Shanahan F. The effect of exercise interventions on inflammatory biomarkers in healthy, physically inactive subjects: a systematic review. QJM: An International Journal of Medicine. 2017 Oct 1;110(10):629-37.
Manuela Crispim Nascimento C, Rodrigues Pereira J, Pires de Andrade L, Garuffi M, Leme Talib L, Vicente Forlenza O, Maria Cancela J, Regina Cominetti M, Stella F. Physical Exercise in MCI elderly promotes reduction of pro-inflammatory cytokines and improvements on cognition and BDNF peripheral levels. Current Alzheimer Research. 2014 Oct 1;11(8):799-805.
Tsuk S, Netz Y, Dunsky A, Zeev A, Carasso R, Dwolatzky T, Salem R, Behar S, Rotstein A. The acute effect of Exercise on executive function and attention: resistance versus aerobic Exercise. Advances in cognitive psychology. 2019;15(3):208.
Angulo J, El Assar M, Álvarez-Bustos A, Rodríguez-Mañas L. Physical activity and Exercise: Strategies to manage frailty. Redox biology. 2020 Aug 1;35:101513.
Stamou MI, Colling C, Dichtel LE. Adrenal ageing and its effects on the stress response and immunosenescence. Maturitas. 2023 Feb 1;168:13-9.
Shields GS, Sazma MA, Yonelinas AP. The effects of acute stress on core executive functions: A meta-analysis and comparison with cortisol. Neuroscience & Biobehavioral Reviews. 2016 Sep 1;68:651-68.
Wilson RS, Arnold SE, Schneider JA, Kelly JF, Tang Y, Bennett DA. Chronic psychological distress and risk of Alzheimer’s disease in old age. Neuroepidemiology. 2006 Oct 27;27(3):143-53.
Ouanes S, Popp J. High cortisol and the risk of dementia and Alzheimer's disease: a literature review. Frontiers in ageing neuroscience. 2019 Mar 1;11:43.
Tortosa-Martínez J, Manchado C, Cortell-Tormo JM, Chulvi-Medrano I. Exercise, the diurnal cortisol cycle and cognitive impairment in older adults. Neurobiology of stress. 2018 Nov 1;9:40-7.
JAWWAD G, ANJUM AF, RASUL A, ARSHAD S, IFTIKHAR M, RIZVI A, LALIQUE T. Role of Exercise in modulating neuroendocrine response to psychological stress. Age (years). 2021;30:6.
Ross A, Thomas S. The health benefits of yoga and Exercise: a review of comparison studies. The journal of alternative and complementary medicine. 2010 Jan 1;16(1):3-12.
Corazza DI, Sebastião É, Pedroso RV, Andreatto CA, de Melo Coelho FG, Gobbi S, Teodorov E, Santos-Galduróz RF. Influence of chronic Exercise on serum cortisol levels in older adults. European Review of Aging and Physical Activity. 2014 Apr;11(1):25-34.
Wang C, Bannuru R, Ramel J, Kupelnick B, Scott T, Schmid CH. Tai Chi on psychological well-being: systematic review and meta-analysis. BMC complementary and alternative medicine. 2010 Dec;10(1):1-6.
Siddarth D, Siddarth P, Lavretsky H. An observational study of the health benefits of yoga or tai chi compared with aerobic Exercise in community-dwelling middle-aged and older adults. The American journal of geriatric psychiatry. 2014 Mar 1;22(3):272-3.
Sanders LM, Hortobagyi T, la Bastide-van Gemert S, van der Zee EA, van Heuvelen MJ. Dose-response relationship between Exercise and cognitive function in older adults with and without cognitive impairment: a systematic review and meta-analysis. PloS one. 2019 Jan 10;14(1):e0210036.
Smith PJ, Blumenthal JA, Hoffman BM, Cooper H, Strauman TA, Welsh-Bohmer K, Browndyke JN, Sherwood A. Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials. Psychosomatic medicine. 2010 Apr;72(3):239.
Wayne PM, Walsh JN, Taylor‐Piliae RE, Wells RE, Papp KV, Donovan NJ, Yeh GY. Effect of Tai Chi on cognitive performance in older adults: Systematic review and meta-analysis. Journal of the American Geriatrics Society. 2014 Jan;62(1):25-39.
Gothe NP, Keswani RK, McAuley E. Yoga practice improves executive function by attenuating stress levels. Biological psychology. 2016 Dec 1;121:109-16.
Barha CK, Davis JC, Falck RS, Nagamatsu LS, Liu-Ambrose T. Sex differences in exercise efficacy to improve cognition: a systematic review and meta-analysis of randomized controlled trials in older humans. Frontiers in neuroendocrinology. 2017 Jul 1;46:71-85.
Wu C, Yi Q, Zheng X, Cui S, Chen B, Lu L, Tang C. Effects of mind‐body exercises on cognitive function in older adults: A meta‐analysis. Journal of the American Geriatrics Society. 2019 Apr;67(4):749-58.
Zhang Y, Li C, Zou L, Liu X, Song W. The effects of mind-body Exercise on cognitive performance in elderly: a systematic review and meta-analysis. International Journal of Environmental Research and Public Health. 2018 Dec;15(12):2791.
Sáez de Asteasu ML, Martínez-Velilla N, Zambom-Ferraresi F, Casas-Herrero Á, Cadore EL, Galbete A, Izquierdo M. Assessing the impact of physical Exercise on cognitive function in older medical patients during acute hospitalization: Secondary analysis of a randomized trial. PLoS medicine. 2019 Jul 5;16(7):e1002852.
Colcombe S, Kramer AF. Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychological science. 2003 Mar;14(2):125-30.
Wang Y, Tian J, Yang Q. Tai Chi exercise improves working memory capacity and emotion regulation ability. Frontiers in Psychology. 2023 Feb 17;14:1047544.
Northey JM, Cherbuin N, Pumpa KL, Smee DJ, Rattray B. Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. British journal of sports medicine. 2018 Feb 1;52(3):154-60.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Ghulshan Ara, Syed Meeran Hasnain, Asha, Muhammad Haris Raza, Maria Parvez, Misbah Alnoor
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
