Short communicationEffect of handball training on cognitive ability in elderly with mild cognitive impairment
Introduction
Mild cognitive impairment (MCI) represents a transitional state between healthy aging and very mild Alzheimer disease (AD) [28]. Elderly individuals with MCI are at high risk for developing AD. There are about 10–15% of MCI patients develop AD each year [13], [19], and normal elderly subjects convert to AD at a rate of only 1–2% per year [5]. At present, using the same medication that is used to treat AD is the most common method used to treat MCI intervention. However, researchers concluded that currently, no effective pharmacological treatments exist for MCI patients [1], especially with regard to long-term beneficial effects. A recent systematic review did not report convincing effects in delayed disease progression or conversion to dementia in MCI patients treated with cholinesterase inhibitors (I-ChEs), and the authors reported important risks associated with the I-ChE treatment [23]. A recent review recommends engagement of MCI persons in cognitive activities and participation in social activities, given that these might be beneficial and pose little risk [21].
Epidemiological data suggests that regular participation in physical activity, especially aerobic exercise, is associated with a lower risk of dementia [4], [16], [17], [33]. According to these findings, epidemiological studies and randomized controlled trials examining the effects of exercise have proposed it is associated with various cognitive benefits [4], [8], [9], [24], [29], [30], and several meta-analyses reported that physical activity or exercise is associated with improvements in attention, processing speed, and executive function in older adults with or without cognitive impairments [2], [7], [27]. RCT have been conducted to determine the effects of exercise or physical activity on cognitive functions in older adults with MCI. Several studies identified the effects of muticomponent exercise on cognitive function in older adults with MCI and found it is beneficial for improving logical memory and maintaining general cognitive function and reducing whole brain cortical atrophy in older adults with amnestic MCI [29], [30]. A study further compared effects of multicomponent exercise and resistance training on executive cognitive functions and functional mobility in older adults and the results confirmed that both physical training benefits executive function and suggest that different training types might lead to such benefits through different pathways, both types of training promoted functional mobility in older adulthood [12]. In addition to muticomponent erxercise, Rovner demonstrated that a self-designed behavior activation could prevent cognitive decline in older African Americans [24], Cyarto proved that home-based physical activity may delay the progression of white matter changes on MRI in older adults with memory complaints and MCI through a single-blind randomized controlled trial conducted in 156 participants [8], and Erickson found that moderate-intensity aerobic exercise training was effective at reversing hippocampal volume loss in late adulthood, which is accompanied by improved memory function [10].
Based on the evidence of the relationship between exercise and cognitive function in MCI, the current study was designed to test whether a 6-month supervised handball training program could improve cognitive function among older adults with MCI. The reason for examining this program was because recently researches have confirmed that handball training program can enhance intelligence in children [6], [15], [20], but no findings about its effect on cognitive function among older adults with MCI has been reported. Handball combines the elements of fitness endurance, hand-eye coordination, agility and strategy in any given game through the use of handball for some actions such as cast, throw and so on. Previous reviews have suggested that multiple exercise interventions improve mobility among older adults [14], [27].
Section snippets
Participants
This study was conducted from October 2011 to August 2012. A total of 60 aged patients with mild cognitive impairment (MCI) were selected according to the US mental disorders 4th edition of the Diagnostic and Statistical Manual (DSM-IV) [3] in mild neurocognitive damage standards and the Diagnosis standard of Shanghai Mental Health Center [26].
Inclusion standards: (1) ages ranged from 60 to 75 years old; (2) existing subjective or objective cognitive impairment; (3) mini-mental state
Results
Table 2 shows the results of the gait analyses at baseline and after the intervention. There were no significant differences in the gait variables between the two groups at baseline (P£3/40.05). MMSE score was increased and ADL score was decreased in training group after 3-month and 6-month intervention (P < 0.05), while there were no significant changes in MMSE or ADL in control group (P£3/40.05). In a multivariate repeated measure analysis of variance, handball training was associated with
Discussion
Older adults with MCI have been found to exhibit greater decreases in memory function than in other cognitive functions, relative to healthy older adults [22]. The enhancement of cognitive function, especially memory function, in individuals with MCI may play a crucial role in preventing the progression from MCI to AD in older adults. There was a significant group × time interaction on the MMSE and ADL scores in present study, which means six months of handball training improved cognitive
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