Document Detail

Endurance and strength training outcomes on cognitively impaired and cognitively intact older adults: a meta-analysis.
MedLine Citation:
PMID:  18548179     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Dementia is a common syndrome in the geriatric population. Subsequent impairment of cognitive functioning impacts the patient's mobility, ADLs, and IADLs. It is suggested that older persons with lower levels of cognition are less likely to achieve independence in ADLs and ambulation (1-2). Frequently, nursing home residents are viewed as too frail or cognitively impaired to benefit from exercise rehabilitation. Often, persons with Mini Mental State Score (MMSE) score below 25 are excluded from physical rehabilitation programs. However, Diamond (3) and Goldstein (4) concluded that geriatric patients with mild to moderate cognitive impairment were just as likely as cognitively intact patients to improve in functional abilities as a result of participation in exercise rehabilitation programs.
PURPOSE: The objective of this study is to compare, through a meta-analysis endurance and strength outcomes of Cognitively Impaired (MMSE < 23) and Cognitively Intact (MMSE superior 24) older adults who participate in similar exercise programs.
METHODS: Published articles were identified by using electronic and manual searches. Key search words included exercise, training, strength, endurance, rehabilitation, cognitive impairment, cognition, MMSE, older adult, aged, and geriatrics. Articles were included if the were from RCTs or well-designed control studies.
RESULTS: A total of 41 manuscripts met the inclusion criteria. We examined 21 exercise trials with cognitively impaired individuals (CI=1411) and 20 exercise trials with cognitively intact individuals (IN=1510). Degree of cognitive impairment is based on the reported MMSE score. Moderate to large effect sizes (ES = dwi, Hedges gi) were found for strength and endurance outcomes for the CI groups (dwi = .51, 95% CI= .42- .60), and for the IN groups (dwi = .49, 95% CI= .40- .58). No statistically significant difference in ES was found between the CI and IN studies on strength (t=1.675, DF= 8, P= .132), endurance (t=1.904, DF= 14, P=.078), and combined strength and endurance effects (t=1.434, DF= 56, P= .263).
CONCLUSIONS: These results suggest that cognitively impaired older adults who participate in exercise rehabilitation programs have similar strength and endurance training outcomes as age and gender matched cognitively intact older participants and therefore impaired individuals should not be excluded from exercise rehabilitation programs.
P C Heyn; K E Johnson; A F Kramer
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  The journal of nutrition, health & aging     Volume:  12     ISSN:  1279-7707     ISO Abbreviation:  J Nutr Health Aging     Publication Date:    2008 Jun-Jul
Date Detail:
Created Date:  2008-06-12     Completed Date:  2009-01-06     Revised Date:  2014-09-10    
Medline Journal Info:
Nlm Unique ID:  100893366     Medline TA:  J Nutr Health Aging     Country:  France    
Other Details:
Languages:  eng     Pagination:  401-9     Citation Subset:  IM    
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MeSH Terms
Activities of Daily Living
Aged, 80 and over
Cognition Disorders / rehabilitation*
Geriatrics / methods,  statistics & numerical data
Neuropsychological Tests / statistics & numerical data
Physical Endurance*
Resistance Training / methods*,  statistics & numerical data*
Severity of Illness Index
Treatment Outcome
Grant Support
R01 AG025032/AG/NIA NIH HHS; R01 AG025032-01/AG/NIA NIH HHS; R37 AG025667/AG/NIA NIH HHS

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