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Open Access 01-12-2024 | Systematic Review

The effectiveness of multicomponent exercise in older adults with cognitive frailty: a systematic review and meta-analysis

Authors: Huanhuan Luo, Zitian Zheng, Zhe Yuan, Huixiu Hu, Chao Sun

Published in: Archives of Public Health | Issue 1/2024

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Abstract

Background

Cognitive frailty, intimately tied to adverse outcomes such as falls, early mortality, and hospitalization, represents a dynamic, reversible process. Multicomponent exercise has emerged as one of the most potent means of mitigating cognitive frailty.

Aims

This research seeks to quantitively amalgamate the effects of multicomponent exercise on various domains: cognitive function, frailty status, and other health-related outcomes in cognitively frail older adults.

Methods

Our methodology entailed a comprehensive review of literature in databases including PubMed, EMbase, CINAHL, Cochrane Library, Web of Science, Wanfang, Sinomed, VIP, and CNKI from the inception of these databases to December 10, 2023. For our statistical analysis, we utilized RevMan 5.3, Stata 17.0 and R 4.3.2 software. Adherence was maintained to the PRISMA checklist, with the study being registered with PROSPERO (CRD42024499808).

Results

Our review encapsulated a total of 2,222 participants and 11 trials. The findings intimate that multicomponent exercise enhances cognitive function [MD = 2.52, p = 0.03]), grip strength[SMD = 0.39, p = 0.008] and lower limb muscle strength[MD = 4.30, p < 0.001], while alleviating frailty[MD = -2.21, p < 0.001] and depression [MD = -1.20, p = 0.001]. However, cogent evidence is still lacking to endorse the positive effects of multicomponent exercises on both ADL(p = 0.19) and quality of life(p = 0.16). Subgroup analyses revealed beneficial effects on cognitive frailty for multicomponent exercise whose type of exercise consisted of aerobic, the duration of which exceeded 120 min per week, and whose form of exercise was group exercise.

Conclusion

Multicomponent exercises offer significant improvements in cognitive function, muscle strength, and have the added benefit of reducing frailty and depression in older adults. However, these exercises do not appear to influence activities of daily living and quality of life positively.
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Literature
1.
Kelaiditi E, Cesari M, Canevelli M, van Kan GA, Ousset PJ, Gillette-Guyonnet S, Ritz P, Duveau F, Soto ME, Provencher V, et al. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group. J Nutr Health Aging. 2013;17(9):726–34.PubMedCrossRef
2.
Sugimoto T, Arai H, Sakurai T. An update on cognitive frailty: Its definition, impact, associated factors and underlying mechanisms, and interventions. Geriatr Gerontol Int. 2022;22(2):99–109.PubMedCrossRef
3.
Qiu Y, Li G, Wang X, Zheng L, Wang C, Wang C, Chen L. Prevalence of cognitive frailty among community-dwelling older adults: A systematic review and meta-analysis. Int J Nurs Stud. 2022;125:104112.PubMedCrossRef
4.
Tang KF, Teh PL, Lee SWH. Cognitive frailty and functional disability among community-dwelling older adults: a systematic review. Innov Aging. 2023;7(1):igad005.PubMedPubMedCentralCrossRef
5.
Guo X, Pei J, Ma Y, Cui Y, Guo J, Wei Y, Han L. Cognitive frailty as a predictor of future falls in older adults: a systematic review and meta-analysis. J Am Med Dir Assoc. 2023;24(1):38–47.PubMedCrossRef
6.
Zou C, Yu Q, Wang C, Ding M, Chen L. Association of depression with cognitive frailty: a systematic review and meta-analysis. J Affect Disord. 2023;320:133–9.PubMedCrossRef
7.
Qiu Y, Li G, Zheng L, Liu W, Li X, Wang X, Chen L. Relationship between cognitive frailty and mortality in older adults: a systematic review and meta-analysis. J Am Med Dir Assoc. 2023;24(11):1637–1644.e1638.PubMedCrossRef
8.
Shimada H, Makizako H, Tsutsumimoto K, Doi T, Lee S, Suzuki T. Cognitive frailty and incidence of dementia in older persons. J Prev Alzheimers Dis. 2018;5(1):42–8.PubMed
9.
Panza F, Lozupone M, Solfrizzi V, Sardone R, Dibello V, Di Lena L, D’Urso F, Stallone R, Petruzzi M, Giannelli G, et al. Different cognitive frailty models and health- and cognitive-related outcomes in older age: from epidemiology to prevention. J Alzheimers Dis. 2018;62(3):993–1012.PubMedPubMedCentralCrossRef
10.
Arai H, Satake S, Kozaki K. Cognitive frailty in geriatrics. Clin Geriatr Med. 2018;34(4):667–75.PubMedCrossRef
11.
Liang JH, Xu Y, Lin L, Jia RX, Zhang HB, Hang L. Comparison of multiple interventions for older adults with Alzheimer disease or mild cognitive impairment: A PRISMA-compliant network meta-analysis. Medicine (Baltimore). 2018;97(20):e10744.PubMedCrossRef
12.
Yan J, Li X, Guo X, Lin Y, Wang S, Cao Y, Lin H, Dai Y, Ding Y, Liu W. Effect of Multicomponent Exercise on Cognition, Physical Function and Activities of Daily Life in Older Adults With Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil. 2023;104(12):2092–108.PubMedCrossRef
13.
Hernández SSS, Sandreschi PF, da Silva FC, Arancibia BAV, da Silva R, Gutierres PJB, Andrade A. What are the benefits of exercise for Alzheimer’s disease? a systematic review of the past 10 years. J Aging Phys Act. 2015;23(4):659–68.PubMedCrossRef
14.
Li Y, Gao Y, Hu S, Chen H, Zhang M, Yang Y, Liu Y. Effects of multicomponent exercise on the muscle strength, muscle endurance and balance of frail older adults: A meta-analysis of randomised controlled trials. J Clin Nurs. 2023;32(9–10):1795–805.PubMedCrossRef
15.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100.PubMedPubMedCentralCrossRef
16.
Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898.
17.
Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, Henry D, Altman DG, Ansari MT, Boutron I, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355: i4919.PubMedPubMedCentralCrossRef
18.
19.
20.
Chen X, Zhao L, Liu Y, Zhou Z, Zhang H, Wei D, et al. Otago exercise programme for physical function and mental health among older adults with cognitive frailty during COVID-19: a randomised controlled trial. J Clin Nurs. 2021. https://​doi.​org/​10.​1111/​jocn.​15964.
21.
Cardalda IM, López A, Carral JMC. Arch Gerontol Geriatr. 2019;83:223–30.CrossRef
22.
Dorner T, Kranz A, Zettl-Wiedner K, Ludwig C, Rieder A, Gisinger C. The effect of structured strength and balance training on cognitive function in frail, cognitive impaired elderly long-term care residents. Aging Clin Exp Res. 2007;19(5):400–5.PubMedCrossRef
23.
Liu Z, Hsu FC, Trombetti A, King AC, Liu CK, Manini TM, Fielding RA, Pahor M, Newman AB, Kritchevsky S, et al. Effect of 24-month physical activity on cognitive frailty and the role of inflammation: the LIFE randomized clinical trial. BMC Med. 2018;16(1):185.PubMedPubMedCentralCrossRef
24.
Casas-Herrero Á, de Sáez AML, Antón-Rodrigo I, Sánchez-Sánchez JL, Montero-Odasso M, Marín-Epelde I, Ramón-Espinoza F, Zambom-Ferraresi F, Petidier-Torregrosa R, Elexpuru-Estomba J, et al. Effects of Vivifrail multicomponent intervention on functional capacity: a multicentre, randomized controlled trial. J Cachexia Sarcopenia Muscle. 2022;13(2):884–93.PubMedPubMedCentralCrossRef
25.
Ye M, Li S, Zhu Z, Zhu H. Effect of a multicomponent exercise prescription in elderly patients with cognitive frailty. Chin General Pract. 2021;24(04):460–6.
26.
Chen B, Li M, Zhao H, Liao R, Lu J, Tu J, Zou Y, Teng X, Huang Y, Liu J, et al. Effect of multicomponent intervention on functional decline in chinese older adults: a multicenter randomized clinical trial. J Nutr Health Aging. 2023;27(11):1063–75.PubMedCrossRef
27.
Feng H, Zou Z, Zhang Q, Wang L, Ouyang YQ, Chen Z, Ni Z. The effect of the group-based Otago exercise program on frailty among nursing home older adults with cognitive impairment. Geriatr Nurs. 2021;42(2):479–83.PubMedCrossRef
28.
Zhu YZ, Lin CF, Yang HL, Jin G, Chiu HL. Effects of exergaming on cognitive functions and loneliness of older adults with cognitive frailty. Int J Geriatr Psychiatry. 2023;38(6):e5944.PubMedCrossRef
29.
Merchant RA, Chan YH, Hui RJY, Tsoi CT, Kwek SC, Tan WM, Lim JY, Sandrasageran S, Wong BLL, Chen MZ, et al. Motoric cognitive risk syndrome, physio-cognitive decline syndrome, cognitive frailty and reversibility with dual-task exercise. Exp Gerontol. 2021;150:111362.PubMedCrossRef
30.
31.
32.
Gertz K, Priller J, Kronenberg G, Fink KB, Winter B, Schröck H, Ji S, Milosevic M, Harms C, Böhm M, et al. Physical activity improves long-term stroke outcome via endothelial nitric oxide synthase-dependent augmentation of neovascularization and cerebral blood flow. Circ Res. 2006;99(10):1132–40.PubMedCrossRef
33.
Zhang P, Yu H, Zhou N, Zhang J, Wu Y, Zhang Y, Bai Y, Jia J, Zhang Q, Tian S, et al. Early exercise improves cerebral blood flow through increased angiogenesis in experimental stroke rat model. J Neuroeng Rehabil. 2013;10:43.PubMedPubMedCentralCrossRef
34.
Viboolvorakul S, Patumraj S. Exercise training could improve age-related changes in cerebral blood flow and capillary vascularity through the upregulation of VEGF and eNOS. Biomed Res Int. 2014;2014:230791.PubMedPubMedCentralCrossRef
35.
Courel-Ibáñez J, Buendía-Romero Á, Pallarés JG, García-Conesa S, Martínez-Cava A, Izquierdo M. Impact of tailored multicomponent exercise for preventing weakness and falls on nursing home residents’ functional capacity. J Am Med Dir Assoc. 2022;23(1):98–104.e103.PubMedCrossRef
36.
Yi M, Zhang W, Zhang X, Zhou J, Wang Z. The effectiveness of Otago exercise program in older adults with frailty or pre-frailty: a systematic review and meta-analysis. Arch Gerontol Geriatr. 2023;114: 105083.PubMedCrossRef
37.
Venegas-Sanabria LC, Cavero-Redondo I, Martínez-Vizcaino V, Cano-Gutierrez CA, Álvarez-Bueno C. Effect of multicomponent exercise in cognitive impairment: a systematic review and meta-analysis. BMC Geriatr. 2022;22(1):617.PubMedPubMedCentralCrossRef
38.
Kim H, Suzuki T, Kim M, Kojima N, Ota N, Shimotoyodome A, Hase T, Hosoi E, Yoshida H. Effects of exercise and milk fat globule membrane (MFGM) supplementation on body composition, physical function, and hematological parameters in community-dwelling frail Japanese women: a randomized double blind, placebo-controlled, follow-up trial. PLoS ONE. 2015;10(2):e0116256.PubMedPubMedCentralCrossRef
39.
Cadore EL, Casas-Herrero A, Zambom-Ferraresi F, Idoate F, Millor N, Gómez M, Rodriguez-Mañas L, Izquierdo M. Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. Age (Dordr). 2014;36(2):773–85.PubMedCrossRef
40.
Lin TY, Chen JJ, Lin LL, Ou Yang WT, Chen MY, Tsai YC. Effects of multicomponent exercise training on muscle oxygenation in young and older adults. J Exerc Sci Fit. 2023;21(1):138–46.PubMedCrossRef
41.
Ströhle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm (Vienna). 2009;116(6):777–84.PubMedCrossRef
42.
Kvam S, Kleppe CL, Nordhus IH, Hovland A. Exercise as a treatment for depression: a meta-analysis. J Affect Disord. 2016;202:67–86.PubMedCrossRef
43.
Schuch FB, Stubbs B. The role of exercise in preventing and treating depression. Curr Sports Med Rep. 2019;18(8):299–304.PubMedCrossRef
44.
Eyre HA, Acevedo B, Yang H, Siddarth P, Van Dyk K, Ercoli L, Leaver AM, Cyr NS, Narr K, Baune BT, et al. Changes in neural connectivity and memory following a yoga intervention for older adults: a pilot study. J Alzheimers Dis. 2016;52(2):673–84.PubMedPubMedCentralCrossRef
45.
Yadav R, Yadav RK, Khadgawat R, Pandey RM. Comparative efficacy of a 12 week yoga-based lifestyle intervention and dietary intervention on adipokines, inflammation, and oxidative stress in adults with metabolic syndrome: a randomized controlled trial. Transl Behav Med. 2019;9(4):594–604.PubMedCrossRef
46.
Schuch FB, Deslandes AC, Stubbs B, Gosmann NP, Silva CT, Fleck MP. Neurobiological effects of exercise on major depressive disorder: a systematic review. Neurosci Biobehav Rev. 2016;61:1–11.PubMedCrossRef
47.
Romera-Liebana L, Orfila F, Segura JM, Real J, Fabra ML, Möller M, Lancho S, Ramirez A, Marti N, Cullell M, et al. Effects of a primary care-based multifactorial intervention on physical and cognitive function in frail, elderly individuals: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2018;73(12):1688–1674.PubMedCrossRef
48.
Gallardo-Gómez D, Del Pozo-Cruz J, Noetel M, Álvarez-Barbosa F, Alfonso-Rosa RM, Del Pozo CB. Optimal dose and type of exercise to improve cognitive function in older adults: A systematic review and bayesian model-based network meta-analysis of RCTs. Ageing Res Rev. 2022;76:101591.PubMedCrossRef
49.
Izquierdo M, Duque G, Morley JE. Physical activity guidelines for older people: knowledge gaps and future directions. Lancet Healthy Longev. 2021;2(6):e380–3.PubMedCrossRef
50.
Schuch FB, Vasconcelos-Moreno MP, Borowsky C, Zimmermann AB, Wollenhaupt-Aguiar B, Ferrari P, de Almeida Fleck MP. The effects of exercise on oxidative stress (TBARS) and BDNF in severely depressed inpatients. Eur Arch Psychiatry Clin Neurosci. 2014;264(7):605–13.PubMedCrossRef
51.
Stødle IV, Debesay J, Pajalic Z, Lid IM, Bergland A. The experience of motivation and adherence to group-based exercise of Norwegians aged 80 and more: a qualitative study. Arch Public Health. 2019;77:26.PubMedPubMedCentralCrossRef
Metadata
Title
The effectiveness of multicomponent exercise in older adults with cognitive frailty: a systematic review and meta-analysis
Authors
Huanhuan Luo
Zitian Zheng
Zhe Yuan
Huixiu Hu
Chao Sun
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Archives of Public Health / Issue 1/2024
Electronic ISSN: 2049-3258
DOI
https://doi.org/10.1186/s13690-024-01441-y

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