Thursday, 12 June 2014

Systematic Exercise: A non-pharmaceutical approach for enhancing Adult Neuroplastcity and Reducing Cognitive Decline

                                 


So far it has been hypothesized that systematic exercise programs and Active Lifestyle has a very significantly positive effect on enhancing human cognition,executive functions and memory in both adult and pediatric population. A number of research have come up with significant evidence for supporting this notion. Physical exercise is an efficient non-pharmaceutical approach that can be used to enhance and maintain cognitive function in healthy older adults and patients suffering from mild cognitive impairment ( Louis Beher& Kirk.L.Erickson 2013).

In a study conducted in 2012 by Lindsay.S.Nagamatsu et all showed that Physical activity helps to improve verbal and spatial memory in older adults with probable mild cognitive impairment.In this study 86 women aged between subjective memory complaints completed one of the 3 interventions twice/ week for 6 months resistance training, aerobic training and or balance and tone. They tested verbal memory using Rey Auditory Verbal Learning Test (RAVLT) and spatial memory using computerized test before and after trial completion. Both exercise groups showed significant improvement in memory performance which was not observed in the control group.
A single blinded RCT conducted in 2010 by Teresa Liu-Ambrose et all concluded that once weekly or twice weekly resistance training benefited the executive cognitive functions of selected attention and conflict resolution among senior woman. In this study 155 community dwelling woman aged(65-75) were randomly allocated into once weekly(n=54) twice weekly(n=52) resistance training group and twice weekly balance and tone training group(n=49) (control group). The primary outcome measure was performance on the Stroop Test, an executive cognitive test of selective attention and Conflict resolution. The secondary outcome measures were working memory, verbal memory, brain volume, gait speed and muscular function.The results were very remarkable. Both resistance training groups significantly improved there performance on the Stroop test compared with those in the control group ( P≤ .03). Task performance improved by 12.6% and 10.9% in the once weekly and twice weekly resistance training group. where as it reduced by 0.5% in the control group.Enhanced selective attention and conflict resolution was significantly associated with increased gait speed. However the study also found reduction in brain volume in both the experimental groups as compared to control group.

These evidences flash light on the fact that structured and scientifically designed exercise programs help to enhance neuroplasticty and neurogenesis in aging Maintaining functional pasticity of the Cortex is essential for healthy aging. Aerobic exercise and resistance training may be an effective behavioral intervention to promote functional plasticity among seniors. Teresa Liu-Ambrose et all have showed in 2011 that 12 months of twice  weekly  resistance training caused functional changes and increase in hemodynamic activity in 2 cortical regions associated with response inhibition process. the cortical areas are left middle temporal gyrus and the left anterior insular extending into lateral orbital cortex. 


Research performed by Takao Suzuki et all in 2013 showed that exercise intervention are beneficial  for improving logical memory and maintaining general cognitive function and reducing whole brain cortical atrophy in older adults with amenstic mild cognitive impairment(MCI). Subjects were 100 100 adults ( mean age 75)with MCI.The subjects were classified into amnestic MCI group ( n=50) with neuroimaging measures and other MCI group (N=50) before the randomization.Subjects in each groups were randomized to either a multicomponent exercise or an education control group using a ratio of 1:1. The exercise group exercise for 90min./day, 2day/wk/40 times for 6 months.These exercise program was  conducted under multi-task condition to simulate working memory and attention.The control group attended 2 education class.A repeated measure ANOVA revealed that no group into x time interactions in the cognitive test and brain atrophy in MCI patients.A sub analysis of amnestic MCI patients for group x time interactions revealed that the exercise group exhibited significantly better mini mental state examination (p=.04) and logical memory scores (p=.04) and reducing whole brain cortical atrophy(p<.05) compared to the control group.

All these evidences points to the fact that exercise interventions needs to be incorporated into the geriatric and amenestic populations treatment plans and daily life routines.It is also necessary that exercise specialists and clinicians should update the current research and promote multidisciplinary approach in  geriatric and aging population management.Just like the Medical community exercise science professionals also should  give emphasis to evidence based practice of exercise physiology , clinical exercise physiology and exercise science.One of the main goal of this article is to promote evidence based practice among exercise science professionals. 


Siby C Chacko BPE, MPE (Exercise Physiology)       


REFERENCES

1) Louis Behar, Kirk.L.Erickson and Teresa Liu Ambrose , Physical exercise and brain function in 
     older adults (2013) Journal of aging research ch:1,p.no-1 to 3.

2) Lindsay.S.Nagamastu ,Alison Chan, Jennifer.C.Devis, Lynn Beattie, Physical activity improves verbal
    and spatial memory in older adults with probable mild cognitive impairment: A 6 month RCT (2013)
     J.of Aging Res. Article ID 861893.pp-10.

3) Teresa Liu Ambrose et all , Resistance Training and Executive Functions: A12 month RCT (2010)JAMA      vol.-170,No.2 

4) T.Suzuki,Shimada.H, Makizako.H,Doi.T, Yoshida.D, A RCT of Multicomponent Exercise in Older 
     adults with Mild Cognitive Impairment.( 2013) PloS one: 2013, 8(4): g61483.


      

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