Effect of resistance-exercise training on cognitive function in healthy older adults: a review

Several studies have demonstrated that exercise helps reduce or prevent cognitive deterioration among older adults, and recent studies have further examined the effects of resistance-exercise training on cognition. The purpose of this review was to examine the role of resistance-exercise training on cognition in healthy older adults. Specifically, it describes the definition, health benefits, and the design of resistance-exercise training. The authors also review the research related to resistance exercises and cognition and found that this exercise modality may enhance specific cognitive performances. Next, they examine the potential mechanisms underlying resistance exercise and cognitive enhancement. Finally, they consider potential therapeutics and recommendations for further research on resistance-exercise training and cognition in older adults.     

Anabolic responses to resistance training in older men and women: a brief review

Resistance training has been shown to be the most effective exercise mode to induce anabolic adaptations in older men and women. Advances in imaging techniques and histochemistry have increased the ability to detect such changes, confirming the high level of adaptability that remains in aging skeletal muscle. This brief review presents a summary of the resistance-training studies that directly compare chronic anabolic responses to training in older (>60 years) men and women. Sixteen studies are summarized, most of which indicate similar relative anabolic responses between older men and women after resistance training. Relatively small sample sizes in most of the interventions limited their ability to detect significant sex differences and should be considered when interpreting these studies. Future research should incorporate larger sample sizes with multiple measurement time points for anabolic responses.     

Resistive training and long-term function in older adults

The purpose of this study was to evaluate the effects of a 24-month moderate-intensity resistive-training intervention on strength and function in older adults. A repeated-measures experimental research design was employed as a sample of 55 apparently healthy, older, community-dwelling volunteers (30 exercisers- 25 women and 5 men; 25 comparisons- 16 women and 9 men) were evaluated for strength of 5 muscle groups that influence lower extremity movement and physical function. Strength and function were evaluated at 6-month intervals. The findings from this study indicate that a moderate-intensity resistive-training program increases strength in older adults and that the strength benefits are retained for the duration of the intervention. Furthermore, a long-term strength-training program can increase independent-function skills in older adults and might therefore aid in prolonging functional independence.     

Functional benefit of power training for older adults

Aging leads to significant losses in muscle mass, strength, and the ability to independently perform activities of daily living (ADL). Typically, standard resistance training (RT) has been used to reduce these losses in function by maintaining or even increasing muscle strength in older adults. Increasing strength does not necessarily, however, result in an increase in the ability to perform ADL. There is now research suggesting that muscle power is more closely associated with the performance of ADL than muscle strength is, so training for muscle power might lead to more beneficial results in functional performance. This review of studies investigating the effect of training on ADL performance in older adults indicated that standard RT is effective in increasing strength in older adults, but power training that contains high-velocity contractions might be a more optimal means of training older adults when the emphasis is on increasing the performance of ADL.     

The relevance of situation awareness in older adults’ cognitive functioning: a review

Age-related declines in cognition may have detrimental effects on older adults’ ability to complete everyday activities that young- and middle-aged individuals perform automatically. Theories of cognitive aging have found deficits in older adults’ fluid intelligence, capacity for inhibition, number of processing resources, and speed of processing, and in recent years, studies have proposed cognitive strategies to ameliorate these declines. However, few strategies directly train the cognitive strategies necessary to improve performance in dynamic environments and physical activities. One such strategy may be the enhancement of situation awareness, the capability to perceive and understand one’s environment. Although the term has typically been applied to pilots and other expert performers, situation awareness may also be relevant to cognitive aging, where older adults’ perception and comprehension of their environment become critical to everyday functioning and physical activities. If older adults’ situation awareness can be facilitated, then it may be possible to reduce the impact of age-related cognitive declines, allowing older adults to successfully participate in dynamic situations and sports where the environment is constantly changing (e.g., driving and tennis). The following review outlines cognitive deficits in aging, details their relation to situation awareness, and discusses how training in situation awareness may reduce cognitive declines. Portions of this paper were reported at the annual meeting of the North American Society for the Psychology of Sport and Physical Activity in June, 2005.     

Effects of multicomponent training on functional fitness in older adults

The purpose of this study was to evaluate the effects of a 9-week supervised multicomponent exercise program on functional fitness and body composition in independent older adults. Forty-two adults age 60-86 years were randomly assigned to an exercise or a control group and were evaluated before and after training. The training program consisted of 3 sessions of walking, strengthening, and flexibility exercises per week. The multicomponent training program resulted in significant (p < .005) improvements on the chair stand, arm curl, 6-min walk, and up-and-go tests. The findings of this study indicate that a 9-week training program increased upper and lower body strength, aerobic endurance, and agility/dynamic balance in older adults. The most affected components of functional fitness were lower body strength and aerobic endurance. There was no effect of the 9-week training on body composition.     

The effects of strength training on memory in older adults

The authors examined whether resistance training has an effect on working memory span. Participants included 210 community-residing older adults with at least one disability from the Strong for Life program, a randomized controlled trial that examined the effects of home-based resistance exercise. Memory was assessed with the WAIS backward digit span at baseline and 3 and 6 months into the intervention. Although there were no differences between the experimental treatment and control groups in average levels of memory change, within the treatment group change in resistance level during the intervention was a significant predictor of memory change, controlling for age, education, sex, and disability level. The results suggest that strength training can benefit memory among older adults, especially when using higher resistance levels.     

Suitability of physical activity questionnaires for older adults in fall-prevention trials: a systematic review

The purpose of the study was to identify physical activity questionnaires for older adults that might be suitable outcome measures in clinical trials of fall-injury-prevention intervention and to undertake a systematic quality assessment of their measurement properties. PubMed, CINAHL, and PsycINFO were systematically searched to identify measurements and articles reporting the methodological quality of relevant measures. Quality extraction relating to content, population, reliability, validity, responsiveness, acceptability, practicality, and feasibility was undertaken. Twelve outcome measures met the inclusion criteria. There is limited evidence about the measures' properties. None of the measures is entirely satisfactory for use in a large-scale trial at present. There is a need to develop suitable measures. The Stanford 7-day Physical Activity Recall Questionnaire and the Community Health Activities Model Program for Seniors questionnaire might be appropriate for further development. The results have implications for the designs of large-scale trials investigating many different geriatric syndromes.     

The motor-learning process of older adults in eccentric bicycle ergometer training

This study describes the motor-learning process of older individuals during the course of a training intervention on a motor-driven eccentric bicycle ergometer. Seventeen women and 16 men (64 ± 6 yr) took part in a 10-wk training program. Uniformity of force production and consistency of timing were used to describe their motor performance. The results suggested that participants improved the coefficient of variation of peak force during the intervention (measured at the 2nd, 4th, 6th, 8th, 10th, 12th, and the 18th training sessions). They reached a fairly constant level of motor performance around the 12th training session (5 wk). Age and sex affected improvements in the early phases of the learning process to an extent, but the differences diminished by the end of the intervention. These results suggest that the force control of continuous eccentric muscle contractions improves as a result of training in older adults.     

Transition from home care to nursing home: unmet needs in a home- and community-based program for older adults

A major effort is under way nationally to shift long-term care services from institutional to home- and community-based settings. This article employs quantitative and qualitative methods to identify unmet needs of consumers who transition from a statewide home- and community-based service program for older adults to long-term nursing home residence. Administrative data, care manager notes, and focus group discussions identified program service gaps that inadequately accommodated acute health problems, mental health issues, and stressed family caregivers; additional unmet needs highlighted an inadequate workforce, transportation barriers, and limited supportive housing options. National and state-level policy implications are considered.     

Gambling among culturally diverse older adults: a systematic review of qualitative and quantitative data

Culturally diverse older gamblers may face multiple jeopardies and socially structured challenges. In this first systematic review of empirical evidence of gambling in this population, the authors examined both quantitative and qualitative studies published between 1996 and June 2016. A thorough search of 7 databases yielded 18 articles with a total sample of 11,296 culturally diverse older adults. The review revealed contrary findings on the correlation between gender, education, income and gambling behaviour. Early onset was more frequently found among older adults who belonged to a culture that promoted tolerance of gambling activities; however, some developed a gambling habit after they had moved to a western society. Using an analytical framework, the authors demonstrate interrelated factors: enabling factors (cultural acceptance of gambling, supportive social networks, accessibility to gambling facilities and venues, and external cues); motivational factors (desire for excitement and winning money, coping with boredom, and stress due to structural issues); and buffering factors for culturally diverse older gamblers . Both environmental and personal factors could be triggered as buffers between gambling and culturally diverse older adults. In light of the motivational and enabling factors, practitioners and policy makers may need to step beyond focusing on ‘correction’ during intervention.     

The effect of functional circuit training on physical frailty in frail older adults: a randomized controlled trial

The purpose of this study was to evaluate whether a 12-wk functional circuit-training program (FCT) could alter markers of physical frailty in a group of frail community-dwelling adults. Fifty-one individuals (31 women, 20 men), mean age (± SD) 84 (± 2.9) yr, met frailty criteria and were randomly assigned into groups (FCT = 26, control group [CG] = 25). FCT underwent a 12-wk exercise program. CG met once a week for health education meetings. Measures of physical frailty, function, strength, balance, and gait speed were assessed at Weeks 0, 12, and 36. Physical-frailty measures in FCT showed significant (p < .05) improvements relative to those in CG (Barthel Index at Weeks 0 and 36: 73.41 (± 2.35) and 77.0 (± 2.38) for the FCT and 70.79 (± 2.53) and 66.73 (± 2.73) for the CG. These data indicate that an FCT program is effective in improving measures of function and reducing physical frailty among frail older adults.     

Effects of strength and power training on neuromuscular variables in older adults

The purpose of this study was to compare the neuromuscular adaptations produced by strength-training (ST) and power-training (PT) regimens in older individuals. Participants were balanced by quadriceps cross-sectional area (CSA) and leg-press 1-repetition maximum and randomly assigned to an ST group (n = 14; 63.6 ± 4.0 yr, 79.7 ± 17.2 kg, and 163.9 ± 9.8 cm), a PT group (n = 16; 64.9 ± 3.9 yr, 63.9 ± 11.9 kg, and 157.4 ± 7.7 cm), or a control group (n = 13; 63.0 ± 4.0 yr, 67.2 ± 10.8 kg, and 159.8 ± 6.8 cm). ST and PT were equally effective in increasing (a) maximum dynamic and isometric strength (p < .05), (b) increasing quadriceps muscle CSA (p < .05), and (c) decreasing electrical mechanical delay of the vastus lateralis muscle (p < .05). There were no significant changes in neuromuscular activation after training. The novel finding of the current study is that PT seems to be an attractive alternative to regular ST to maintain and improve muscle mass.     

Systematic review of functional training on muscle strength,physical functioning,and activities of daily living in older adults

Exercise programs are often recommended for preventing or delaying late-life disability. Programs that incorporate functional training, which uses movements similar to performing activities of daily living, may be suitable for such recommendation. The purpose of this systematic review was to examine the effects of functional training on muscle strength, physical functioning, and activities of daily living in older adults. Studies in three electronic databases (MEDLINE, CINAHL, and SPORTDiscus) were searched, screened, and appraised. Thirteen studies were included in the review. These studies vary greatly in participant recruitment criteria, functional training content, and selection of comparison groups. Mobility exercises were the most common element in functional training across studies. Results show beneficial effects on muscle strength, balance, mobility, and activities of daily living, particularly when the training content was specific to that outcome. Functional training may be used to improve functional performance in older adults.     

Accelerometry analysis of physical activity and sedentary behavior in older adults: a systematic review and data analysis

Accelerometers objectively monitor physical activity and sedentary patterns and are increasingly used in the research setting. It is important to maintain consistency in data analysis and reporting, therefore, we: (1) systematically identified studies using accelerometry (ActiGraph, Pensacola, FL, USA) to measure moderate-to-vigorous physical activity (MVPA) and sedentary time in older adults, and (2) based on the review findings, we used different cut-points obtained to analyze accelerometry data from a sample of community-dwelling older women. We identified 59 articles with cut-points ranging between 574 and 3,250 counts/min for MVPA and 50 and 500 counts/min for sedentary time. Using these cut-points and data from women (mean age, 70 years), the median MVPA minutes per day ranged between 4 and 80 min while percentage of sedentary time per day ranged between 62 % and 86 %. These data highlight (1) the importance of reporting detailed information on the analysis assumptions and (2) that results can differ greatly depending on analysis parameters.     

Effect of ceasing creatine supplementation while maintaining resistance training in older men

The authors previously found that creatine (Cr) combined with 12 weeks of resistance training enhanced muscle strength and endurance and lean tissue mass (LTM) in older men. Their purpose in this study was to assess these variables with cessation of Cr combined with 12 weeks of reduced training (33% lower volume) in a subgroup of these men (n = 8, 73 years old) compared with 5 men (69 years old) who did not receive Cr. Strength (1-repetition maximum [1-RM]), endurance (maximum number of repetitions over 3 sets at 70-80% 1-RM), and LTM (dual-energy X-ray absorptiometry) were assessed before and after 12 weeks of Cr cessation combined with reduced-volume training. No changes in strength or LTM occurred. Muscle endurance was significantly reduced (7-21%; p <.05), with the rate of change similar between groups. Withdrawal from Cr had no effect on the rate of strength, endurance, and loss of lean tissue mass with 12 weeks of reduced-volume training.     

Effect of resistance training on single muscle fiber contractile function in older men

Reproduced with permission     

Schizophrenia in older adults

Although the number of people older than 55 with schizophrenia is expected to double during the next 20 years, the research data on older adults with schizophrenia are limited. This appears to be because until the middle of the 20th century, it was assumed that mental illness in older adults was a part of the aging process and because older adults are often excluded from research investigations. Nursing research is needed to explore how people with schizophrenia learn to manage their problems as they age, as well as how those who are first diagnosed with schizophrenia in later life adapt to their illness. Mental health nurses need to be cautious in assigning premature labels to older adults with mental illness that may lead to unsubstantiated assumptions about levels of disability. Instead, nurses should realize individual potential regarding undiscovered strengths and should attempt to create interventions that recognize and foster personal development for older adults with schizophrenia.