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Int J Sports Med 2020; 41(12): 815-823
DOI: 10.1055/a-1186-1272
Review

Meta-analysis: Resistance Training Improves Cognition in Mild Cognitive Impairment

Lulu Zhang 
1   Xiangya Hospital, Central South University, Changsha, China
2   Xiangya Nursing School, Central South University, Changsha, China
,
Bin Li
3   National Clinical Research Center for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital Central South University, Changsha, China
,
Jingjing Yang
1   Xiangya Hospital, Central South University, Changsha, China
,
Fengling Wang
1   Xiangya Hospital, Central South University, Changsha, China
,
Qianyun Tang
1   Xiangya Hospital, Central South University, Changsha, China
,
Shuhong Wang
1   Xiangya Hospital, Central South University, Changsha, China
› Author Affiliations Funding: The authors thank the National Key Research and Development Program of China (Grant no. 2018YFC2002400).
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Abstract

This study investigated the benefits of resistance training on cognition in patients with mild cognitive impairment. We searched the PubMed, Embase and Cochrane Library databases, and seven randomized controlled trials were reviewed. We evaluated the risk of bias using the Cochrane Collaboration’s bias assessment tool. Standard mean differences with 95% confidence intervals were calculated for statistical analysis. This meta-analysis assessed three variables: general cognitive function, executive function and working memory. The results indicate that general cognitive function improved significantly (standardized mean difference: 0.53, P=0.04), and further subgroup analyses on frequency and duration per session showed that the subgroups ‘twice a week’ (P=0.01) and ‘duration per session >60 min’ (P=0.0006) exhibited better performance than the subgroups ‘three time a week’ (P=0.47) and ‘duration per session <60 min’ (P=0.53). Additionally, a moderate effect size was found in executive function (standardized mean difference: 0.50, P=0.0003), and there was non-significant effect in working memory (P=0.14). In summary, resistance training may mitigate mild cognitive impairment by improving cognition. Larger-scale studies are recommended to demonstrate the relationship between resistance training and cognition in mild cognitive impairment.

Key words

exercise therapy - cognitive dysfunction - mild cognitive impairment - randomized controlled trials as topic - meta-analysis

Supplementary Material



Publication History

Received: 18 January 2020

Accepted: 13 May 2020

Article published online:
29 June 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Gauthier S, Reisberg B, Zaudig M. et al. Mild cognitive impairment. Lancet 2006; 367: 1262-1270
    CrossrefPubMedSearch in Google Scholar
  • 2 Mufson EJ, Chen EY, Cochran EJ. et al. Entorhinal cortex beta-amyloid load in individuals with mild cognitive impairment. Exp Neurol 1999; 158: 469-490
    CrossrefPubMedSearch in Google Scholar
  • 3 Gotovac K, Nikolac PM, Pivac N. et al. Biomarkers of aggression in dementia. Prog Neuropsychopharmacol Biol Psychiatry 2016; 69: 125-130
    CrossrefPubMedSearch in Google Scholar
  • 4 Ritchie K. Mild cognitive impairment: an epidemiological perspective. Dialogues Clin Neurosci 2004; 6: 401-408
    CrossrefPubMedSearch in Google Scholar
  • 5 Sachdev PS, Lipnicki DM, Kochan NA. et al. The prevalence of mild cognitive impairment in diverse geographical and ethnocultural regions: The COSMIC Collaboration. PLoS One 2015; 10: e0142388
    CrossrefPubMedSearch in Google Scholar
  • 6 Callahan KE, Lovato JF, Miller ME. et al. Associations between mild cognitive impairment and hospitalization and readmission. J Am Geriatr Soc 2015; 63: 1880-1885
    CrossrefPubMedSearch in Google Scholar
  • 7 Ganguli M, Dodge HH, Shen C. et al. Mild cognitive impairment, amnestic type. Neurology 2004; 63: 115
    CrossrefPubMedSearch in Google Scholar
  • 8 Tricco AC, Soobiah C, Berliner S. et al. Efficacy and safety of cognitive enhancers for patients with mild cognitive impairment: A systematic review and meta-analysis. CMAJ 2013; 185: 1393-1401
    CrossrefPubMedSearch in Google Scholar
  • 9 Gates N, Fiatarone Singh MA, Sachdev PS. et al. The effect of exercise training on cognitive function in older adults with mild cognitive impairment: A meta-analysis of randomized controlled trials. Am J Geriatr Psychiatry 2013; 21: 1086-1097
    CrossrefPubMedSearch in Google Scholar
  • 10 Liang JH, Xu Y, Lin L. et al. Comparison of multiple interventions for older adults with Alzheimer disease or mild cognitive impairment: A PRISMA-compliant network meta-analysis. Medicine 2018; 97: e10744
    CrossrefPubMedSearch in Google Scholar
  • 11 Yaffe K, Haan M, Blackwell T. et al. Metabolic syndrome and cognitive decline in elderly Latinos: Findings from the Sacramento Area Latino study of aging study. J Am Geriatr Soc 2007; 55: 758-762
    CrossrefPubMedSearch in Google Scholar
  • 12 Pedersen BK. The anti-inflammatory effect of exercise: Its role in diabetes and cardiovascular disease control. Essays Biochem 2006; 42: 105-117
    CrossrefPubMedSearch in Google Scholar
  • 13 Cotman CW, Berchtold NC, Christie LA. et al. Exercise builds brain health: Key roles of growth factor cascades and inflammation. Trends Neurosci 2007; 30: 464-472
    CrossrefPubMedSearch in Google Scholar
  • 14 Fabel K, Fabel K, Tam B. et al. VEGF is necessary for exercise-induced adult hippocampal neurogenesis. Eur J Neurosci 2003; 18: 2803-2812
    CrossrefPubMedSearch in Google Scholar
  • 15 Ahlskog JE, Geda YE, Graff-Radford NR. et al. Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clin Proc 2011; 86: 876-884
    CrossrefPubMedSearch in Google Scholar
  • 16 Adlard PA, Perreau VM, Pop V. et al. Voluntary exercise decreases amyloid load in a transgenic model of Alzheimer’s disease. J Neurosci 2005; 25: 4217-4221
    CrossrefPubMedSearch in Google Scholar
  • 17 Khodadadi D, Gharakhanlou R, Naghdi N. et al. Treadmill exercise ameliorates spatial learning and memory deficits through improving the clearance of peripheral and central amyloid-beta levels. Neurochem Res 2018; 43: 1561-1574
    CrossrefPubMedSearch in Google Scholar
  • 18 He XF, Liu DX, Zhang Q. et al. Voluntary exercise promotes glymphatic clearance of amyloid beta and reduces the activation of astrocytes and microglia in aged mice. Front Mol Neurosci 2017; 10: 144
    CrossrefPubMedSearch in Google Scholar
  • 19 Nigam SM, Xu S, Kritikou JS. et al. Exercise and BDNF reduce Abeta production by enhancing alpha-secretase processing of APP. J Neurochem 2017; 142: 286-296
    CrossrefPubMedSearch in Google Scholar
  • 20 Garnaes KK, Morkved S, Salvesen KA. et al. Exercise training during pregnancy reduces circulating insulin levels in overweight/obese women postpartum: Secondary analysis of a randomised controlled trial (the ETIP trial). BMC Pregnancy Childbirth 2018; 18: 18
    CrossrefPubMedSearch in Google Scholar
  • 21 Swaminathan SK, Ahlschwede KM, Sarma V. et al. Insulin differentially affects the distribution kinetics of amyloid beta 40 and 42 in plasma and brain. J Cereb Blood Flow Metab 2018; 38: 904-918
    CrossrefPubMedSearch in Google Scholar
  • 22 Odetti P, Piccini A, Giliberto L. et al. Plasma levels of insulin and amyloid beta 42 are correlated in patients with amnestic mild cognitive impairment. J Alzheimers Dis 2005; 8: 243-245
    CrossrefPubMedSearch in Google Scholar
  • 23 Holten MK, Zacho M, Gaster M. et al. Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes 2004; 53: 294-305
    CrossrefPubMedSearch in Google Scholar
  • 24 Davis JC, Bryan S, Marra CA. et al. An economic evaluation of resistance training and aerobic training versus balance and toning exercises in older adults with mild cognitive impairment. PLoS One 2013; 8: e63031
    CrossrefPubMedSearch in Google Scholar
  • 25 Vancampfort D, Stubbs B, Firth J. et al. Associations between handgrip strength and mild cognitive impairment in middle-aged and older adults in six low- and middle-income countries. Int J Geriatr Psychiatry 2019; 34: 609-616
    CrossrefPubMedSearch in Google Scholar
  • 26 Li Z, Peng X, Xiang W. et al. The effect of resistance training on cognitive function in the older adults: A systematic review of randomized clinical trials. Aging Clin Exp Res 2018; 30: 1259-1273
    CrossrefPubMedSearch in Google Scholar
  • 27 Lu J, Sun M, Liang L. et al. Effects of momentum-based dumbbell training on cognitive function in older adults with mild cognitive impairment: A pilot randomized controlled trial. Clin Interv Aging 2015; 11: 9-16
    CrossrefPubMedSearch in Google Scholar
  • 28 Yoon DH, Kang D, Kim HJ. et al. Effect of elastic band-based high-speed power training on cognitive function, physical performance and muscle strength in older women with mild cognitive impairment. Geriatr Gerontol Int 2017; 17: 765-772
    CrossrefPubMedSearch in Google Scholar
  • 29 Fiatarone Singh MA, Gates N, Saigal N. et al. The Study of Mental and Resistance Training (SMART) study-resistance training and/or cognitive training in mild cognitive impairment: A randomized, double-blind, double-sham controlled trial. J Am Med Dir Assoc 2014; 15: 873-880
    CrossrefPubMedSearch in Google Scholar
  • 30 Hong SG, Kim JH, Jun TW. et al. Effects of 12-week resistance exercise on electroencephalogram patterns and cognitive function in the elderly with mild cognitive impairment: A randomized controlled trial. Clin J Sport Med 2018; 28: 500-508
    CrossrefPubMedSearch in Google Scholar
  • 31 Tsai CL, Pai MC, Ukropec J. et al. Distinctive effects of aerobic and resistance exercise modes on neurocognitive and biochemical changes in individuals with mild cognitive impairment. Curr Alzheimer Res 2019; 16: 316-332
    CrossrefPubMedSearch in Google Scholar
  • 32 Yoon DH, Lee JY, Song W. et al. Effects of resistance exercise training on cognitive function and physical performance in cognitive frailty: A randomized controlled trial. J Nutr Health Aging 2018; 22: 944-951
    CrossrefPubMedSearch in Google Scholar
  • 33 Moher D, Liberati A, Tetzlaff J. et al. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. J Clin Epidemiol 2009; 62: 1006-1012
    CrossrefPubMedSearch in Google Scholar
  • 34 Harriss DJ, MacSween A, Atkinson G. et al. Ethical Standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817
    Thieme ConnectPubMedSearch in Google Scholar
  • 35 Petersen RC, Roberts RO, Knopman DS. et al. Mild cognitive impairment: Ten years later. Arch Neurol 2009; 66: 1447-1455
    CrossrefPubMedSearch in Google Scholar
  • 36 Strauss EH, Sherman EMS, Spreen O. et al. A Compendium of Neuropsychological Tests: Administration, Norms and Commentary. Oxford, United Kingdom: Oxford University Press; 2006
    CrossrefSearch in Google Scholar
  • 37 Nagamatsu LS, Chan A, Davis JC. et al. Physical activity improves verbal and spatial memory in older adults with probable mild cognitive impairment: A 6-month randomized controlled trial. J Aging Res 2013; 2013: 861893
    CrossrefPubMedSearch in Google Scholar
  • 38 ten Brinke LF, Bolandzadeh N, Nagamatsu LS. et al. Aerobic exercise increases hippocampal volume in older women with probable mild cognitive impairment: A 6-month randomised controlled trial. Br J Sports Med 2015; 49: 248-254
    CrossrefPubMedSearch in Google Scholar
  • 39 Nagamatsu LS, Handy TC, Hsu CL. et al. Resistance training promotes cognitive and functional brain plasticity in seniors with probable mild cognitive impairment. Arch Intern Med 2012; 172: 666-668
    CrossrefPubMedSearch in Google Scholar
  • 40 Busse AL, Filho WJ, Magaldi RM. et al. Effects of resistance training exercise on cognitive performance in elderly individuals with memory impairment: Results of a controlled trial. Einstein 2008; 6: 402-407
    PubMedSearch in Google Scholar
  • 41 Davies G, Lam M, Harris SE. et al. Study of 300,486 individuals identifies 148 independent genetic loci influencing general cognitive function. Nat Commun 2018; 9: 2098
    CrossrefPubMedSearch in Google Scholar
  • 42 Mavros Y, Gates N, Wilson GC. et al. Mediation of cognitive function improvements by strength gains after resistance training in older adults with mild cognitive impairment: Outcomes of the study of mental and resistance training. J Am Geriatr Soc 2017; 65: 550-559
    CrossrefPubMedSearch in Google Scholar
  • 43 Miller LA, Spitznagel MB, Busko S. et al. Structured exercise does not stabilize cognitive function in individuals with mild cognitive impairment residing in a structured living facility. Int J Neurosci 2011; 121: 218-223
    CrossrefPubMedSearch in Google Scholar
  • 44 Flicker C, Ferris SH, Reisberg B. et al. Mild cognitive impairment in the elderly: Predictors of dementia. Neurology 1991; 41: 1006-1009
    CrossrefPubMedSearch in Google Scholar
  • 45 Marshall GA, Rentz DM, Frey MT. et al. Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer’s disease. Alzheimers Dement 2011; 7: 300-308
    CrossrefPubMedSearch in Google Scholar
  • 46 Zheng G, Xia R, Zhou W. et al. Aerobic exercise ameliorates cognitive function in older adults with mild cognitive impairment: A systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 2016; 50: 1443-1450
    CrossrefPubMedSearch in Google Scholar
  • 47 Song D, Yu DSF, Li PWC. et al. The effectiveness of physical exercise on cognitive and psychological outcomes in individuals with mild cognitive impairment: A systematic review and meta-analysis. Int J Nurs Stud 2018; 79: 155-164
    CrossrefPubMedSearch in Google Scholar
  • 48 Landrigan JF, Bell T, Crowe M et al. Lifting cognition: A meta-analysis of effects of resistance exercise on cognition. Psychol Res 2020; 84: 1167–1183
    PubMed
  • 49 Liu-Ambrose T, Nagamatsu LS, Voss MW. et al. Resistance training and functional plasticity of the aging brain: a 12-month randomized controlled trial. Neurobiol Aging 2012; 33: 1690-1698
    CrossrefPubMedSearch in Google Scholar
  • 50 Baddeley A. Working memory: Theories, models, and controversies. Annu Rev Psychol 2012; 63: 1-29
    CrossrefPubMedSearch in Google Scholar
  • 51 Bennett DA, Schneider JA, Bienias JL. et al. Mild cognitive impairment is related to Alzheimer disease pathology and cerebral infarctions. Neurology 2005; 64: 834-841
    CrossrefPubMedSearch in Google Scholar
  • 52 Dani M, Wood M, Mizoguchi R. et al. Tau aggregation correlates with amyloid deposition in both mild cognitive impairment and alzheimer’s disease subjects. J Alzheimers Dis 2019; 70: 455-465
    CrossrefPubMedSearch in Google Scholar
  • 53 Fan LY, Tzen KY, Chen YF. et al. The Relation between brain amyloid deposition, cortical atrophy, and plasma biomarkers in amnesic mild cognitive impairment and alzheimer’s disease. Front Aging Neurosci 2018; 10: 175
    CrossrefPubMedSearch in Google Scholar
  • 54 Huijbers W, Mormino EC, Schultz AP. et al. Amyloid-beta deposition in mild cognitive impairment is associated with increased hippocampal activity, atrophy and clinical progression. Brain 2015; 138: 1023-1035
    CrossrefPubMedSearch in Google Scholar
  • 55 Broadhouse KM, Singh MF, Suo C. et al. Hippocampal plasticity underpins long-term cognitive gains from resistance exercise in MCI. Neuroimage Clin 2020; 25: 102182
    CrossrefPubMedSearch in Google Scholar