Structured exercise for Cognitive Decline

Although many older adults have some complaints about their eyesight and/or hearing, only 2% are affected by both, compared with 1% for both and vision or hearing complaints alone.

Cognitive deficits in brain injury patients are associated with deficits in some specific cognitive functions; more rigorous evaluation of the contribution of other factors to cognitive deficits in brain injured patients is needed to maximize their potential therapeutic benefits.

Cognitive decline is common in older adults. There is only one FDA-approved treatment for cognitive decline: [acetylcholinesterase (AChE) inhibitor or mamestrol]. Older adults are also being prescribed a wider variety of over-the-counter treatments and supplements, including multiple AChE inhibitor products, and even non-acetyl cholinesterase (non-AChE) inhibitors, that could improve, but not cure cognitive functioning.

The prevalence of at least one cognitive impairment is a significant predictor of functional decline in the community as well as in-home assessments of functional ability. Older persons with elevated risk factors for cognitive decline, such as a history of stroke, have an increased hazard of functional decline. The clinical presentation of cognition should thus be evaluated routinely and the appropriate preventive and management strategies evaluated and addressed.

In terms of treatment success, a significant proportion of persons, regardless of diagnosis, showed modest improvement by 6 and 12 months respectively. However, there were no associations between the magnitude of neuropsychological test improvements and the magnitude of change in self-reported function. Findings from a recent study suggest a dissociation between clinically-observed, quantifiable improvements in neuropsychological functioning and clinically-observed improvements in perceived functioning.

Although studies on the effects of a number of variables from early disease stages (e.g., younger patient age, less severe impairment, better function overall) were not fully informative, this study provides preliminary evidence of the potential causal impact of a variety of factors, beyond the traditional ones of age and disease severity, on cognitive decline among people with multiple myeloma.

The present meta-review revealed that exercise had a range of common and unpleasant side effects, which can limit the potential use of exercise interventions in the prevention or treatment of cognitive decline.

There may be a potential benefit to standardized aerobic exercise in improving cognitive function and slowing cognitive decline, however more studies are needed to fully support this conclusion.

Structured exercise may improve quality of life for those with cognitive decline. Recent findings of this observational study suggest that exercise may be a promising avenue to promote health outcomes in this population.

Physicians need to consider the age (over 65), patient preference, motivation and baseline cognition as possible confounders for dementia risk. Inclusion and exclusion criteria may need to be adjusted in the future to prevent enrollment of patients not interested in clinical trials.

The majority of clinicians will support some type of structured exercise as a component of their multimodal treatment for seniors with dementia, and that a large majority recommend that it be implemented at a gradual pace.