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Alzheimer's Research & Therapy Sep 2023Although increasing physical activity (PA) has been suggested to prevent and manage cognitive decline and dementia, its economic impact on healthcare systems and society... (Review)
Review
BACKGROUND
Although increasing physical activity (PA) has been suggested to prevent and manage cognitive decline and dementia, its economic impact on healthcare systems and society is largely unknown. This study aimed to summarize evidence on the cost-effectiveness of PA interventions to prevent and manage cognitive decline and dementia.
METHODS
Electronic databases, including PubMed/MEDLINE, Embase, and ScienceDirect, were searched from January 2000 to July 2023. The search strategy was driven by a combination of subject-heading terms related to physical activity, cognitive function, dementia, and cost-effectiveness. Selected studies were included in narrative synthesis, and extracted data were presented in narrative and tabular forms. The risk of bias in each study was assessed using the Consolidated Health Economic Evaluation Reporting Standards and Consensus on Health Economic Criteria list.
RESULTS
Five of the 11 identified studies focused on individuals with existing dementia. Six of the 11 identified studies focused on individuals with no existing dementia, including 3 on those with mild cognitive impairment (MCI), and 3 on those with no existing MCI or dementia. PA interventions focused on individuals with no existing dementia were found to be cost-effective compared to the control group. Findings were mixed for PA interventions implemented in individuals with existing dementia.
CONCLUSIONS
PA interventions implemented before or during the early stage of cognitive impairment may be cost-effective in reducing the burden of dementia. More research is needed to investigate the cost-effectiveness of PA interventions in managing dementia. Most existing studies used short-term outcomes in evaluating the cost-effectiveness of PA interventions in the prevention and management of dementia; future research should consider adding long-term outcomes to strengthen the study design.
Topics: Humans; Cost-Benefit Analysis; Cognitive Dysfunction; Cognition; Exercise; Dementia
PubMed: 37749587
DOI: 10.1186/s13195-023-01286-7 -
Nutrients Jul 2023Hypertensive disorders of pregnancy (HDP) complicate 5-10% of pregnancies, with resultant lifelong increased risks of cardiovascular disease (CVD). We aimed to describe... (Randomized Controlled Trial)
Randomized Controlled Trial
Hypertensive disorders of pregnancy (HDP) complicate 5-10% of pregnancies, with resultant lifelong increased risks of cardiovascular disease (CVD). We aimed to describe lifestyle behaviours at 6 months post-HDP in four HDP subgroups, and their association with markers of cardiometabolic health. Subgroups were chronic hypertension (CH), gestational hypertension (GH), preeclampsia, and preeclampsia superimposed on chronic hypertension (CH + PE). The BP study is a multi-site, three-arm, randomised controlled trial. At 6 months postpartum, the NSW Population Health Survey and BP surveys collected lifestyle behaviours and demographic data. Body mass index (BMI), waist circumference, and blood pressure (BP) were also assessed. Descriptive statistics, ANOVA and Spearman's correlation coefficients were used. Of 484 women (16% CH, 23% GH, 55% preeclampsia, and 6% CH + PE), 62% were overweight or obese. Only 6% met the recommended five vegetable and two fruit serves per day, and 43% did not meet the recommended 150 min of moderate-vigorous physical activity in five sessions per week. Adherence to both diet and physical activity recommendations was correlated with more favourable cardiometabolic outcomes, including lower BMI, waist circumference, and systolic and diastolic BP. Lifestyle interventions that improve diet and physical activity post-HDP are needed to reduce BP, BMI, and long-term CVD in this high-risk population.
Topics: Pregnancy; Female; Humans; Blood Pressure; Pre-Eclampsia; Hypertension, Pregnancy-Induced; Cardiovascular Diseases; Exercise
PubMed: 37571231
DOI: 10.3390/nu15153294 -
Sensors (Basel, Switzerland) Sep 2023Physical activity and cardiovascular disease (CVD) are intimately linked. Low levels of physical activity increase the risk of CVDs, including myocardial infarction and... (Review)
Review
Physical activity and cardiovascular disease (CVD) are intimately linked. Low levels of physical activity increase the risk of CVDs, including myocardial infarction and stroke. Conversely, when CVD develops, it often reduces the ability to be physically active. Despite these largely understood relationships, the objective measurement of physical activity is rarely performed in routine healthcare. The ability to use sensor-based approaches to accurately measure aspects of physical activity has the potential to improve many aspects of cardiovascular healthcare across the spectrum of healthcare, from prediction, prevention, diagnosis, and treatment to disease monitoring. This review discusses the potential of sensor-based measurement of physical activity to augment current cardiovascular healthcare. We highlight many factors that should be considered to maximise the benefit and reduce the risks of such an approach. Because the widespread use of such devices in society is already a reality, it is important that scientists, clinicians, and healthcare providers are aware of these considerations.
Topics: Humans; Risk Factors; Cardiovascular Diseases; Myocardial Infarction; Stroke; Delivery of Health Care; Exercise
PubMed: 37836984
DOI: 10.3390/s23198154 -
JAMA Network Open Sep 2023Current randomized trial evidence of the effects of physical activity interventions in older adults is mainly from developed countries, with little reliable evidence... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Current randomized trial evidence of the effects of physical activity interventions in older adults is mainly from developed countries, with little reliable evidence from low- and middle-income countries, such as China, where race, culture, and lifestyles differ substantially from those in Western populations.
OBJECTIVE
To evaluate the effects of a multilevel intervention for increasing leisure-time activity levels in Chinese older adults.
DESIGN, SETTING, AND PARTICIPANTS
This cluster randomized trial was conducted from May 2021 to May 2023, including an 8-week intervention period and a follow-up period of 24 months. Eight villages in China were randomly assigned to the intervention (4 villages) or the control (4 villages) group. Potentially eligible participants were 60 years or older. A total of 511 older adults from the selected 8 villages were enrolled.
INTERVENTIONS
The intervention group received an 8-week socioecological model-based intervention, comprising individual, interpersonal, and community-level components, whereas the control group did not.
MAIN OUTCOME AND MEASURE
The primary outcome was the change in leisure-time activity at 8 weeks, measured by the Physical Activity Scale for the Elderly (PASE). Possible PASE scores for leisure-time activity range from 0 to 502, with higher scores indicating higher activity levels.
RESULTS
A total of 511 older adults from 8 villages were recruited and randomly allocated to the intervention (240 participants, 4 villages) or control (271 participants, 4 villages) groups. The mean (SD) age was 70.95 (5.72) years, and 284 (55.6%) were female participants. Seven serious adverse events (unrelated deaths) were reported. Participants in the intervention group increased leisure-time activity more than those in the control group, with a mean difference in PASE scores of 13.74 points (95% CI, 8.58-18.91 points) between the groups at 8 weeks (P < .001). Significant differences in leisure-time activity were also found over 24 months (mean difference in scores at 4 weeks, 11.66 points; 95% CI, 6.41-16.90 points; P < .001; at 6 months, 12.35 points; 95% CI, 7.19-17.50 points; P < .001; at 12 months, 11.55 points; 95% CI, 6.32-16.78 points; P < .001; and at 24 months, 14.51 points; 95% CI, 9.28-19.75 points; P < .001).
CONCLUSIONS AND RELEVANCE
In this cluster randomized trial, the multilevel intervention was effective in promoting leisure-time activity over 24 months of follow-up in older adults from China. This finding suggests that implementation of such interventions could be an important step in addressing physical inactivity in older adults in low- and middle-income countries.
TRIAL REGISTRATION
Chinese Clinical Trial Registry Identifier: ChiCTR2100045653.
Topics: Aged; Female; Humans; Male; China; Exercise; Leisure Activities; East Asian People; Health Promotion
PubMed: 37713199
DOI: 10.1001/jamanetworkopen.2023.33195 -
Frontiers in Public Health 2023Gamification has proven to be a significant tool for health promotion, with a particular focus on physical activities such as Exergames, which improve not only physical,... (Review)
Review
BACKGROUND
Gamification has proven to be a significant tool for health promotion, with a particular focus on physical activities such as Exergames, which improve not only physical, but also cognitive health. However, it is still not clear what effect the practice of Exergames has on changing the emotional experience.
PURPOSE
The objective of this systematic review is to evaluate the impact of Exergames training on emotional experience.
METHODS
A systematic search was conducted in the PUBMED and SCOPUS databases. The relevant articles were screened independently by three researchers. Data concerning emotional measures and Exergame practice were extracted for analysis.
RESULTS
The search yielded 38 articles, of which 16 were included. Exergames were found to significantly impact happiness, anxiety, depressive symptoms, mental health-related quality of life, self-worth, self-esteem, self-efficacy, perceived behavioral control, vigor, vitality, intrinsic motivation, perceived energy, and relaxation.
CONCLUSION
Our review supports the evidence that the practice of physical activity through Exergames, on the emotional experience generally generates an increase in positive emotions. In this sense, the results found support both the use of Exergames as a leisure activity that promotes wellbeing and emotional regulation, as well as for health promotion, public health, and clinical practice purposes. Our review strongly supports the notion that engaging in physical activity through Exergames generally leads to an increase in positive emotions. As a result, these findings endorse the utilization of Exergames as a leisure activity to promote well-being and emotional regulation. Moreover, Exergames hold potential for health promotion, public health, and clinical practice purposes.
Topics: Exergaming; Quality of Life; Emotions; Exercise; Anxiety
PubMed: 37744509
DOI: 10.3389/fpubh.2023.1209520 -
The International Journal of Behavioral... Nov 2023Physical activity referral schemes (PARS) are complex multicomponent interventions that represent a promising healthcare-based concept for physical activity (PA)... (Review)
Review
BACKGROUND
Physical activity referral schemes (PARS) are complex multicomponent interventions that represent a promising healthcare-based concept for physical activity (PA) promotion. This systematic review and narrative synthesis aimed to identify the constitutive components of PARS and provide an overview of their effectiveness.
METHODS
Following a published protocol, we conducted a systematic search of PubMed, Scopus, Web of Science, CINAHL, ScienceDirect, SpringerLink, HTA, Wiley Online Library, SAGE Journals, Taylor & Francis, Google Scholar, OpenGrey, and CORE from 1990 to January 2023. We included experimental, quasi-experimental, and observational studies that targeted adults participating in PARS and reported PA outcomes, scheme uptake, or adherence rates. We performed an intervention components analysis using the PARS taxonomy to identify scheme components and extracted data related to uptake, adherence, and PA behavior change. We combined these to provide a narrative summary of PARS effectiveness.
RESULTS
We included 57 studies reporting on 36 PARS models from twelve countries. We identified 19 PARS components: a patient-centered approach, individualized content, behavior change theory and techniques, screening, brief advice, written materials, a written prescription, referral, baseline and exit consultation, counselling support session(s), PA sessions, education session(s), action for non-attendance, structured follow-up, a PA network, feedback for the referrer, and exit strategies/routes. The PARS models contained a mean of 7 ± 2.9 components (range = 2-13). Forty-five studies reported PA outcome data, 28 reported uptake, and 34 reported adherence rates. Of these, approximately two-thirds of studies reported a positive effect on participant PA levels, with a wide range of uptake (5.7-100.0%) and adherence rates (8.5-95.0%).
CONCLUSIONS
Physical activity referral scheme components are an important source of complexity. Despite the heterogeneous nature of scheme designs, our synthesis was able to identify 19 components. Further research is required to determine the influence of these components on PARS uptake, adherence, and PA behavior change. To facilitate this, researchers and scheme providers must report PARS designs in more detail. Process evaluations are also needed to examine implementation and increase our understanding of what components lead to which outcomes. This will facilitate future comparisons between PARS and enable the development of models to maximize impact.
Topics: Adult; Humans; Exercise; Motor Activity; Prescriptions; Referral and Consultation
PubMed: 38012688
DOI: 10.1186/s12966-023-01518-x -
BMC Geriatrics Dec 2023Continuous loss of muscle mass and strength are the consequences of the ageing process, which increase the risk of falls among older people. Falls can lead to severe...
Effectiveness of telehealth in preventive care: a study protocol for a randomised controlled trial of tele-exercise programme involving older people with possible sarcopenia or at risk of fall.
BACKGROUND
Continuous loss of muscle mass and strength are the consequences of the ageing process, which increase the risk of falls among older people. Falls can lead to severe consequences such as bone fractures and hampered physical and psychological well-being. Regular exercise is the key to reversing muscle atrophy and relieving sarcopenia. However, the frailty of older people and the recent COVID-19 pandemic may affect their confidence to leave home to attend classes in the community. A feasible and effective alternative should be explored.
METHODS
The primary objective is to evaluate the effectiveness of tele-exercise (TE) in relation to physical functioning and exercise adherence among community-dwelling older people at risk of falls in comparison with a community-based group (CB). The secondary objective includes evaluating older people's experience with tele-exercise, emphasizing their psychological welfare, social well-being, and acceptance of the telehealth approach. The design, conduct, and report follow the SPIRIT guidelines (Standard Protocol Items: recommended items to address in a Clinical Trial Protocol and Related Documents). Older people will be recruited from 10 local community centres in Hong Kong and randomly allocated into two groups. All participants will attend the exercise training 3 days per week for 3 months but the mode of delivery will differ, either online as the tele-exercise group (TE) or face-to-face as the community-based group (CB). The outcome measures include muscle strength, physical function, exercise adherence and dropout rate, psychological and social well-being will be assessed at the baseline, and the 3rd, 6th and 12th month. Some participants will be invited to attend focus group interviews to evaluate their overall experience of the tele-exercise training.
DISCUSSION
Tele-exercise reduces the barriers to exercise, such as time constraints, inaccessibility to facilities, and the fear of frail older people leaving their homes. Promoting an online home-based exercise programme for older people can encourage them to engage in regular physical activity and increase their exercise adherence even when remaining at home. The use of telehealth can potentially result in savings in cost and time. The final findings will provide insights on delivering exercise via telehealth to older people and propose an exercise delivery and maintenance model for future practice.
TRIAL REGISTRATION
Chinese Clinical Trial Registry ( https://www.chictr.org.cn/hvshowprojectEN.html?id=219002&v=1.1 ), registration number: ChiCTR2200063370. Registered on 5 September 2022.
Topics: Humans; Aged; Sarcopenia; Accidental Falls; Pandemics; Exercise; Exercise Therapy; Telemedicine; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 38093219
DOI: 10.1186/s12877-023-04535-4 -
BMC Public Health Mar 2024Lack of physical activity (PA), poor dietary habits, or other unhealthy lifestyle behaviors are potential modifiable risk factors for hypertension. It has been...
BACKGROUND
Lack of physical activity (PA), poor dietary habits, or other unhealthy lifestyle behaviors are potential modifiable risk factors for hypertension. It has been sufficiently demonstrated in previous studies that physical activity or healthy dietary patterns can reduce the risk of hypertension. However, no research focused on the joint effects of PA and healthy dietary patterns on hypertension in a representative sample of adults.
METHODS
We used data collected from the 2007-2018 National Health and Nutrition Examination Survey. Healthy dietary patterns were assessed with the Healthy Eating Index 2015 (HEI-2015), and PA was measured using the metabolic equivalent minutes per week reported in questionnaires. We created four lifestyle categories based on the HEI-2015 and PA: (1) unhealthy diet and physically inactive (less than recommended PA), (2) healthy diet but physically inactive, (3) unhealthy diet but physically active (recommended PA), (4) healthy diet and physically active. Logistic regression was used to evaluate the association between joint PA and HEI-2015 and hypertension.
RESULTS
A total of 24,453 participants were enrolled in the study. Compared with unhealthy diet and physically inactive individuals, only healthy diet and physically active participants (adjusted odds ratio [AOR]: 0.77, 95% CI 0.65-0.9) were negatively associated with hypertension, while healthy diet but physically inactive participants (AOR: 0.89, 95% CI 0.76-1.03) and unhealthy diet but physically active participants (AOR: 0.9, 95% CI 0.76-1.06) were not associated with hypertension.
CONCLUSION
In a representative sample of US adults, our findings suggest that individuals with recommended PA and healthy dietary patterns have a lower risk of hypertension than those with an unhealthy diet or less than recommended PA. Healthy eating habits and regular PA are potential preventive precautions against hypertension.
Topics: Adult; Humans; Nutrition Surveys; Dietary Patterns; Cross-Sectional Studies; Exercise; Diet; Hypertension
PubMed: 38504199
DOI: 10.1186/s12889-024-18346-8 -
Molecular Metabolism Apr 2024There is significant interest in uncovering the mechanisms through which exercise enhances cognition, memory, and mood, and lowers the risk of neurodegenerative...
OBJECTIVES
There is significant interest in uncovering the mechanisms through which exercise enhances cognition, memory, and mood, and lowers the risk of neurodegenerative diseases. In this study, we utilize forced treadmill running and distance-matched voluntary wheel running, coupled with light sheet 3D brain imaging and c-Fos immunohistochemistry, to generate a comprehensive atlas of exercise-induced brain activation in mice.
METHODS
To investigate the effects of exercise on brain activity, we compared whole-brain activation profiles of mice subjected to treadmill running with mice subjected to distance-matched wheel running. Male mice were assigned to one of four groups: a) an acute bout of voluntary wheel running, b) confinement to a cage with a locked running wheel, c) forced treadmill running, or d) placement on an inactive treadmill. Immediately following each exercise or control intervention, blood samples were collected for plasma analysis, and brains were collected for whole-brain c-Fos quantification.
RESULTS
Our dataset reveals 255 brain regions activated by acute exercise in mice, the majority of which have not previously been linked to exercise. We find a broad response of 140 regulated brain regions that are shared between voluntary wheel running and treadmill running, while 32 brain regions are uniquely regulated by wheel running and 83 brain regions uniquely regulated by treadmill running. In contrast to voluntary wheel running, forced treadmill running triggers activity in brain regions associated with stress, fear, and pain.
CONCLUSIONS
Our findings demonstrate a significant overlap in neuronal activation signatures between voluntary wheel running and distance-matched forced treadmill running. However, our analysis also reveals notable differences and subtle nuances between these two widely used paradigms. The comprehensive dataset is accessible online at www.neuropedia.dk, with the aim of enabling future research directed towards unraveling the neurobiological response to exercise.
Topics: Mice; Male; Animals; Motor Activity; Brain; Physical Conditioning, Animal; Cognition
PubMed: 38428817
DOI: 10.1016/j.molmet.2024.101907 -
International Journal of Circumpolar... Dec 2024A systematic review was conducted to assess evidence on effectiveness of community-based interventions promoting wellbeing and prevention of type 2 diabetes (T2D) among... (Review)
Review
A systematic review was conducted to assess evidence on effectiveness of community-based interventions promoting wellbeing and prevention of type 2 diabetes (T2D) among Indigenous youth. A convergent, segregated, mixed methods approach was used, with six databases and four grey literature sites searched from inception to May 2022. Articles selected for inclusion were about community-based interventions related to T2D prevention with Indigenous youth that evaluated effectiveness or youth experience published in English. Reference lists were also searched for relevant sources. Seven quantitative research articles met the inclusion and quality assessment criteria. No qualitative articles were identified. The results were synthesised through narrative analysis, while meta-analysis was not possible due to heterogenous study designs. Common foci across interventions included promoting physical wellness, improving physical activity and healthy eating patterns, enhancing knowledge, and psychosocial wellness. Interventions deemed effective addressed multiple areas, were school-based, and operated for at least a year. Findings support multi-strategy, community-based interventions implemented over longer periods of time. However, gaps in research and reporting included the extent to which interventions are culturally informed and based on community-driven priorities. Future research should include Indigenous, mixed and qualitative methods and Indigenous-driven measures of success to better understand effectiveness in alignment with Indigenous worldviews.
Topics: Humans; Adolescent; Diabetes Mellitus, Type 2; Exercise; Research Design
PubMed: 38412067
DOI: 10.1080/22423982.2024.2320449