Cognition-oriented treatments for older adults: A systematic review of the influence of depression and self-efficacy individual differences factors.

The increasing prevalence of cognitive decline, mild cognitive impairment (MCI), and dementia with the aging population has led to scrutiny of the efficacy of cognition-oriented treatments (COTs) aiming to maintain functioning, and delay or prevent further cognitive decline. However, little is known regarding the role of individual differences patient-variables (such as depression, self-efficacy, and motivation) in moderating the efficacy of COTs. This systematic review aimed to identify and analyze COT trials which investigated the relationship between differences in these patient-variables and intervention outcomes for older adults across healthy, MCI, and dementia populations. Of the 4854 studies extracted from the systematic search, 14 were included for analysis. While results were mixed across interventions and populations, on balance, greater depression severity predicted poorer cognitive functioning, and improvement in depressive symptom severity may account for at least part of the cognitive benefits seen at post-intervention. These findings were strongest for studies of MCI populations, with there being limited evidence of a relationship for healthy older adults or those with dementia. Overall, this review demonstrates the need for further investigation into the role of individual differences and clinical variables - particularly depression symptom severity - in attenuating COT outcomes through larger sample, high-quality randomized controlled trials.

Muscle Power Predicts Bone Strength in Division II Athletes.

Yingling, VR, Webb, SL, Inouye, C, O, J, and Sherwood, JJ. Muscle power predicts bone strength in Division II athletes. J Strength Cond Res 34(6): 1657-1665, 2020-The relationship between muscle fitness measures and tibial bone strength in collegiate level athletes was investigated. Eighty-six Division II collegiate athletes (mean ± SD: age: [18-29 years], height: 1.71 m [0.09], mass: 66.7 kg [10.5], 56 female: 30 male) participated in this cross-sectional study. Maximum grip strength (GS), 1 repetition maximum leg press, and vertical jump peak power (PP) tests were measured. Cortical area, cortical bone mineral density (cBMD), moment of inertia, and bone strength (polar strength-strain index) were measured using peripheral quantitative computed tomography at 50% tibia length. For each bone strength parameter, a hierarchical multiple regression analysis was performed to examine the contribution of sex and the 3 muscle fitness parameters (muscle power, relative 1 repetition leg extensor strength, and relative GS) to bone parameters. Vertical jump PP explained 54-59% of the variance in bone strength parameters, and relative leg extensor and GS were not predictive of bone strength parameters. Muscle power correlated with bone mass and architecture variables but not cBMD values. Cortical bone mineral density was also not predicted by relative leg extensor strength or relative GS. Muscular fitness assessment, specifically PP calculated from vertical jump height assessments, provides a simple, objective, valid, and reliable measure to identify and monitor bone strength in collegiate athletes.

Reliability and Validity of the Sit-to-Stand as a Muscular Power Measure in Older Adults.

The study aims were to analyze the reliability and validity of the GymAware™ linear position transducer's velocity and power measures during the sit-to-stand, compared with the Dartfish 2D videography analysis, and to assess the relationship of age and handgrip strength with velocity and power in 48 older men and women (77.6 ± 11.1 years). The results showed excellent agreement between GymAware- and Dartfish-derived sit-to-stand velocity (intraclass correlation coefficient2-1 = .94 and power intraclass correlation coefficient2-1 = .98) measures. A moderate and negative relationship was found between age and velocity (r = -.62; p < .001) and age and power (r = -.63; p < .001). A moderate and positive relationship was found between handgrip strength and velocity (r = .43; p = .002) and handgrip strength and power (r = .54; p < .001). The results show the GymAware velocity and power measures during the sit-to-stand in older adults to be reliable and valid.

Relationship between physical and cognitive performance in community dwelling, ethnically diverse older adults: a cross-sectional study.

BACKGROUND: Regular exercise training stimulates physiological adaptations to improve physical performance, reduce chronic disease risk, and slow age-related cognitive decline. Since the physiological mechanisms responsible for aging-associated cognitive decline are not yet fully understood, and training-induced physiological adaptations responsible for performance measure improvements are specific to the type (aerobic vs. strength) and intensity of training, studies are needed to assess the relationships between physical performance measures and cognitive performance in older adults. These results could be used to guide exercise prescriptions with the goal of improving age-related cognitive performance. The purpose of this study was to investigate the relationship between physical performance measures and cognitive performance in a population of community dwelling, ethnically diverse older adults. METHODS: The cognitive performance of ninety independent, community dwelling participants (69 female, 21 male), aged 75 ± 9.5 years (mean ± SD) was measured with the Modified Mini-Mental State Test (3MS), Trailmaking Tests A and B (TMT A & B), and the Animal Naming test. Sociodemographic (age, sex, ethnicity, medication use, years of education) and anthropometric data were collected, physical activity was assessed with the Physical Activity Scale for the Elderly (PASE), peak hand-grip strength, distance walked in the 6MWT, and heart rate pre-, during, and up to 5 min. post- 6MWT were measured. Forward stepwise multiple regression analyses were performed with each cognitive measure as a dependent variable. RESULTS AND DISCUSSION: Controlling for sociodemographic covariates, peak heart rate during the 6MWT (6MWT HRPEAK) was positively correlated with performance in the 3MS (p < 0.017), and TMT A (p < 0.001) and B (p < 0.029). Controlling for sociodemographic covariates, PASE was positively (p = 0.001), and ß-blocker use negatively (p = 0.035), correlated with performance on the Animal Naming test. Also, controlling for sociodemographic covariates, PASE was positively correlated with performance on the TMT A (p = 0.017). Here we show that higher peak heart rate during the 6MWT is positively correlated with cognitive performance in a population of community dwelling, ethnically diverse older adults (ages 60-95 years). CONCLUSION: Higher peak heart rate during the 6MWT was found to be independently and positively correlated with cognitive function in community-dwelling older adults. Although additional work is needed, these results are promising and suggest that physicians, exercise professionals, and/or fitness/fall prevention programs may use peak heart rate during the 6MWT to easily monitor exercise intensity to support cognitive health.

Meta-Analysis of the Effects of Computerized Cognitive Training on Executive Functions: a Cross-Disciplinary Taxonomy for Classifying Outcome Cognitive Factors.

The growing prevalence of neurodegenerative disorders associated with aging and cognitive decline has generated increasing cross-disciplinary interest in non-pharmacological interventions, such as computerized cognitive training (CCT), which may prevent or slow cognitive decline. However, inconsistent findings across meta-analytic reviews in the field suggest a lack of cross-disciplinary consensus and on-going debate regarding the benefits of CCT. We posit that a contributing factor is the lack of a theoretically-based taxonomy of constructs and representative tasks typically used. An integration of the Cattell-Horn-Carroll (CHC) taxonomy of broad and narrow cognitive factors and the Miyake unity-diversity theory of executive functions (EF) is proposed (CHC-M) as an attempt to clarify this issue through representing and integrating the disciplines contributing to CCT research. The present study assessed the utility of this taxonomy by reanalyzing the Lampit et al. (2014) meta-analysis of CCT in healthy older adults using the CHC-M framework. Results suggest that: 1) substantively different statistical effects are observed when CHC-M is applied to the Lampit et al. meta-analytic review, leading to importantly different interpretations of the data; 2) typically-used classification practices conflate Executive Function (EF) tasks with fluid reasoning (Gf) and retrieval fluency (Gr), and Attention with sensory perception; and 3) there is theoretical and practical advantage in differentiating attention and working-memory tasks into the narrow shifting, inhibition, and updating EF domains. Implications for clinical practice, particularly for our understanding of EF are discussed.