European Review of Aging and Physical Activity最新文献

Background: Exercise is increasingly recognized as a non-pharmacological strategy for cognitive aging; however, comparative evidence across modalities, phenotypes, and doses is limited.

Methods: We conducted a Bayesian network meta-analysis of 38 randomized controlled trials (N = 4,047; 88 arms). The interventions included aerobic, resistance, multimodal, and other exercise formats compared with non-exercise controls. The primary outcome was global cognition. Analyses were stratified by age (< 70 vs. ≥70 years) and phenotype (healthy vs. pre-sarcopenic). Dose-response relationships were modeled using the weekly volume (MET·min/week).

Results: Aerobic (standardized mean difference [SMD] 0.58, 95% CI 0.33-0.83), resistance (0.62, 0.35-0.88), and multimodal programs (0.68, 0.40-0.95) significantly improved cognition compared to the control, with smaller effect sizes. Healthy older adults benefited most from aerobic (0.88, 0.55-1.20) and resistance training (0.80, 0.42-1.19), whereas multimodal programs were most effective for pre-sarcopenia (0.60, 0.29-0.90). Dose-response analysis showed clinically meaningful benefits from ~ 600 MET·min/week, with optimal effects between 700 and 1,200 MET·min/week. Higher volumes conferred no consistent additional gains in pre-sarcopenia.

Conclusions: Exercise is a scalable, safe, and clinically effective approach for preserving late-life cognition. For healthy older adults, aerobic or resistance training at ≥ 600 MET·min/week is recommended; for pre-sarcopenic individuals, multimodal programs at approximately 700-800 MET·min/week offer the best balance of efficacy and sustainability. These findings provide actionable targets for clinicians and policymakers, advancing precision exercise prescriptions for cognitive health in aging populations.

Objective: This systematic review and meta-analysis aimed to address key gaps in understanding the role of resistance training (RT) as an intervention to mitigate age-related sarcopenia. Specifically, it examined: (i) effects on body composition and physical performance; (ii) moderating influences of age and training intensity; and (iii) the presence of a dose-response relationship within the FITT-VP framework.

Methods: A comprehensive search of multiple databases identified randomized controlled trials (RCTs) evaluating RT in older adults with sarcopenia. Data on body composition, muscle strength (MS), and functional performance were extracted. Moderator analyses assessed the impact of participant and intervention characteristics, and meta-regression was performed to explore dose-response patterns.

Results: Twenty-five RCTs involving 1,302 participants were included. RT produced significant improvements in MS (ES = 0.71), lean mass (LM, [ES = 0.22]), fat mass (FM, [ES = - 0.17]), walking ability (WA, [ES = 0.41]), grip strength ([GS, [ES = 0.55]), muscle quality (MQ, [ES = 1.25]) (all p < 0.05), but this large effect size was based on only two studies and requires caution interpretation. Dose-response meta-regression revealed a significant non-linear relationship between total RT duration and functional gains, with optimal estimated cumulative volumes of ~ 2,716 min for WA.

Conclusion: RT is a robust, evidence-based strategy for enhancing MS, functional performance, and body composition in sarcopenic older adults. Findings suggest approximate cumulative duration ranges (~ 1,043 min for MS and ~ 2,716 min for WA) that were associated with maximal gains in pooled analyses. These values should be interpreted as exploratory indicators supporting individualized programming within the FITT-VP framework. Clinicians and exercise practitioners should tailor intensity (60-80% 1RM), frequency, and progression to optimize adherence, effectiveness, and long-term functional outcomes in sarcopenia management.

Background: Traditional variable-centred approaches often analyse physical behaviours (sedentary behaviour [SB], light physical activity [LPA], and moderate-to-vigorous physical activity [MVPA]) in isolation, potentially masking their combined effects on outcomes. This study applied latent profile analysis, a person-centred approach, to identify naturally occurring physical behaviour profiles in older adults and examined their associations with physical fitness and physical function.

Methods: This cross-sectional study included 1,095 older Portuguese adults (≥ 65 years; 765 females). SB, LPA, and MVPA were assessed using accelerometry (Actigraph; Pensacola, Florida) on the right hip and expressed as percentages of waking time. Latent profile analysis was used to identify distinct profiles based on these percentages. Physical fitness was evaluated by Senior Fitness Test battery and handgrip strength. Physical function was assessed using the 12-item Composite Physical Function questionnaire. Generalised linear models, adjusted for age, were used to examine associations between profiles and outcomes.

Results: Three distinct profiles emerged for both sexes: "balanced movers" (~ 50% SB, ~ 46% LPA, ~ 4% MVPA), "intermediate movers" (~ 66% SB, ~ 32% LPA, ~ 2% MVPA), and "highly sedentary" (~ 80% SB, ~ 20% LPA, < 1% MVPA). Compared to the "highly sedentary" groups, both "balanced movers" and "intermediate movers" demonstrated better performance on most physical fitness tests and reported higher physical function. Notably, "intermediate movers", performed similarly to "balanced movers" in most measures.

Conclusions: Distinct physical behaviour profiles exist among older Portuguese adults. Profiles characterised by lower SB and higher LPA, even when not fully meeting MVPA recommendations ("intermediate movers"), were associated with better physical fitness and physical function compared to the "highly sedentary" profile. This underscores the importance of reducing SB and promoting LPA along with MVPA. By uncovering these behavioural profiles among older adults, latent profile analysis provides valuable insights to guide the development of more personalized interventions for healthy ageing.

Background: The dose-response effects of physical exercise on brain volume remain insufficiently understood, and it is yet to be established whether exercise-induced relative changes in brain volume translate into improvements in cognitive function. Furthermore, it remains unclear whether specific physical adaptations are associated with both exercise-related changes in brain volume and cognitive outcomes.

Methods: To address these gaps, we conducted a pre-registered systematic review and multilevel meta-analysis of 59 randomized controlled trials comprising a total of 5,099 participants. Comprehensive literature searches were carried out in PubMed, PsycINFO, Embase, and Web of Science up to August 2024. The meta-analysis examined overall effects of physical exercise on brain volume, investigated dose-response effects across relevant moderators, and explored potential mediation pathways linking exercise-induced relative changes in brain volume to cognitive outcomes.

Results: This study found that physical exercise had a significant effect on brain volume. Dose-response analyses further revealed that this effect was more pronounced among individuals of older age, with longer intervention durations and higher compliance. Exercise sessions lasting 40-60 min were associated with the most robust effects on brain volume. Post-hoc analyses suggest that these effects are more likely attributable to the preservation of brain volume rather than substantial volumetric increases. In addition, regression analysis demonstrated a significant positive association between exercise-induced relative changes in brain volume and cognitive function. Moreover, mediation analyses indicated that exercise-induced physical adaptations in muscle function, motor performance, and cardiorespiratory fitness were indirectly associated with cognitive performance through their effects on relative brain volume change.

Conclusions: These findings indicate that physical exercise exerts beneficial effects on brain volume, particularly under conditions such as older age, sufficient exercise duration, and high compliance. Exercise-induced relative changes in brain volume were significantly associated with cognitive function and served as a mediator between physical adaptations and cognitive outcomes. Together, these results provide a mechanistic foundation and practical insights for designing targeted exercise interventions to promote brain health in aging populations.

Trial registration: PROSPERO CRD42024525635.