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June 2018; 8 (3) Review

Exercise for cognitive brain health in aging

A systematic review for an evaluation of dose

Joyce Gomes-Osman, Danylo F. Cabral, Timothy P. Morris, Katalina McInerney, Lawrence P. Cahalin, Tatjana Rundek, Augusto Oliveira, Alvaro Pascual-Leone
First published May 30, 2018, DOI: https://doi.org/10.1212/CPJ.0000000000000460
Joyce Gomes-Osman
From the Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology (JG-O, TPM, AP-L), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Departments of Physical Therapy (JG-O, DFC, LPC), Neurology (JG-O, KM, TR), and Evelyn F. McKnight Institute (JG-O, TR), University of Miami Miller School of Medicine, FL; Departamento de Fisioterapia (DFC, AO), Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, Brazil; Departament de Psicobiologia i Ciències de la Salut (AP-L), Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain; and Institut Guttmann (TPM, AP-L), Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.
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Danylo F. Cabral
From the Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology (JG-O, TPM, AP-L), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Departments of Physical Therapy (JG-O, DFC, LPC), Neurology (JG-O, KM, TR), and Evelyn F. McKnight Institute (JG-O, TR), University of Miami Miller School of Medicine, FL; Departamento de Fisioterapia (DFC, AO), Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, Brazil; Departament de Psicobiologia i Ciències de la Salut (AP-L), Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain; and Institut Guttmann (TPM, AP-L), Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.
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Timothy P. Morris
From the Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology (JG-O, TPM, AP-L), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Departments of Physical Therapy (JG-O, DFC, LPC), Neurology (JG-O, KM, TR), and Evelyn F. McKnight Institute (JG-O, TR), University of Miami Miller School of Medicine, FL; Departamento de Fisioterapia (DFC, AO), Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, Brazil; Departament de Psicobiologia i Ciències de la Salut (AP-L), Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain; and Institut Guttmann (TPM, AP-L), Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.
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Katalina McInerney
From the Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology (JG-O, TPM, AP-L), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Departments of Physical Therapy (JG-O, DFC, LPC), Neurology (JG-O, KM, TR), and Evelyn F. McKnight Institute (JG-O, TR), University of Miami Miller School of Medicine, FL; Departamento de Fisioterapia (DFC, AO), Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, Brazil; Departament de Psicobiologia i Ciències de la Salut (AP-L), Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain; and Institut Guttmann (TPM, AP-L), Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.
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Lawrence P. Cahalin
From the Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology (JG-O, TPM, AP-L), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Departments of Physical Therapy (JG-O, DFC, LPC), Neurology (JG-O, KM, TR), and Evelyn F. McKnight Institute (JG-O, TR), University of Miami Miller School of Medicine, FL; Departamento de Fisioterapia (DFC, AO), Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, Brazil; Departament de Psicobiologia i Ciències de la Salut (AP-L), Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain; and Institut Guttmann (TPM, AP-L), Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.
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Tatjana Rundek
From the Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology (JG-O, TPM, AP-L), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Departments of Physical Therapy (JG-O, DFC, LPC), Neurology (JG-O, KM, TR), and Evelyn F. McKnight Institute (JG-O, TR), University of Miami Miller School of Medicine, FL; Departamento de Fisioterapia (DFC, AO), Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, Brazil; Departament de Psicobiologia i Ciències de la Salut (AP-L), Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain; and Institut Guttmann (TPM, AP-L), Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.
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Augusto Oliveira
From the Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology (JG-O, TPM, AP-L), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Departments of Physical Therapy (JG-O, DFC, LPC), Neurology (JG-O, KM, TR), and Evelyn F. McKnight Institute (JG-O, TR), University of Miami Miller School of Medicine, FL; Departamento de Fisioterapia (DFC, AO), Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, Brazil; Departament de Psicobiologia i Ciències de la Salut (AP-L), Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain; and Institut Guttmann (TPM, AP-L), Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.
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Alvaro Pascual-Leone
From the Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology (JG-O, TPM, AP-L), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Departments of Physical Therapy (JG-O, DFC, LPC), Neurology (JG-O, KM, TR), and Evelyn F. McKnight Institute (JG-O, TR), University of Miami Miller School of Medicine, FL; Departamento de Fisioterapia (DFC, AO), Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, Brazil; Departament de Psicobiologia i Ciències de la Salut (AP-L), Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Spain; and Institut Guttmann (TPM, AP-L), Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.
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Citation
Exercise for cognitive brain health in aging
A systematic review for an evaluation of dose
Joyce Gomes-Osman, Danylo F. Cabral, Timothy P. Morris, Katalina McInerney, Lawrence P. Cahalin, Tatjana Rundek, Augusto Oliveira, Alvaro Pascual-Leone
Neurol Clin Pract Jun 2018, 8 (3) 257-265; DOI: 10.1212/CPJ.0000000000000460

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Abstract

Purpose of review We systematically appraised randomized controlled trials proposing exercise to influence cognition in older adults to (1) assess the methodologic quality using Cochrane criteria; (2) describe various exercise dose measures and assess their relationship with improved cognitive performance; and (3) identify consistent patterns of reported effects on cognition.

Recent findings There was overall good methodologic quality in all 98 included studies. The assessment of the relationship between improved cognition and various measures of exercise dose (session duration, weekly minutes, frequency, total weeks, and total hours) revealed a significant correlation with total hours. Improvements in global cognition, processing speed/attention, and executive function were most stable and consistent.

Summary We found that exercising for at least 52 hours is associated with improved cognitive performance in older adults with and without cognitive impairment. Exercise modes supported by evidence are aerobic, resistance (strength) training, mind–body exercises, or combinations of these interventions.

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  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • Received August 21, 2017.
  • Accepted March 26, 2018.
  • © 2018 American Academy of Neurology
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The Nerve!: Rapid online correspondence

  • Author Response: Exercise for cognitive brain health in aging: A systematic review for an evaluation of dose
    • Timothy P Morris, Post-doctoral research scholar, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School
    • Joyce Gomes-Osman, Assistant professor, Departments of Physical Therapy, Neurology and Evelyn F. McKnight Institute, University of Miami Miller School of Medicine
    • Alvaro Pascual-Leone, Professor in neurology, Associate Dean for Clinical and Translational Research and Chief of Division of Cognitive Neurology, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School
    Submitted August 22, 2018
  • Reader Response: Exercise for cognitive brain health in aging: A systematic review for an evaluation of dose
    • Matthew P. Pase, Senior Research Fellow, The Florey Institute for Neuroscience and Mental Health
    Submitted July 03, 2018
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