Effect of Exercise on Cognitive Performance in Community-Dwelling Older Adults: Review of Intervention Trials and Recommendations for Public Health Practice and Research

Authors

  • Mark Snowden MD, MPH,

    1. From the *Department of Psychiatry and Behavioral Sciences, School of Medicine, Health Promotion Research Center, School of Nursing, University of Washington, Seattle, Washington; §Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; **Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, #National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; ††Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina; ‡‡Michigan Department of Community Health, Lansing, Michigan; §§Center for Stroke Research, Center for Cognitive Medicine; University of Illinois Medical Center at Chicago, Chicago, Illinois; and ##Rollins School of Public Health, Emory University, Atlanta, Georgia.
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  • Lesley Steinman MSW, MPH,

    1. From the *Department of Psychiatry and Behavioral Sciences, School of Medicine, Health Promotion Research Center, School of Nursing, University of Washington, Seattle, Washington; §Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; **Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, #National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; ††Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina; ‡‡Michigan Department of Community Health, Lansing, Michigan; §§Center for Stroke Research, Center for Cognitive Medicine; University of Illinois Medical Center at Chicago, Chicago, Illinois; and ##Rollins School of Public Health, Emory University, Atlanta, Georgia.
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  • Kara Mochan MN, PhD Candidate,

    1. From the *Department of Psychiatry and Behavioral Sciences, School of Medicine, Health Promotion Research Center, School of Nursing, University of Washington, Seattle, Washington; §Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; **Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, #National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; ††Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina; ‡‡Michigan Department of Community Health, Lansing, Michigan; §§Center for Stroke Research, Center for Cognitive Medicine; University of Illinois Medical Center at Chicago, Chicago, Illinois; and ##Rollins School of Public Health, Emory University, Atlanta, Georgia.
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  • Francine Grodstein ScD,

    1. From the *Department of Psychiatry and Behavioral Sciences, School of Medicine, Health Promotion Research Center, School of Nursing, University of Washington, Seattle, Washington; §Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; **Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, #National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; ††Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina; ‡‡Michigan Department of Community Health, Lansing, Michigan; §§Center for Stroke Research, Center for Cognitive Medicine; University of Illinois Medical Center at Chicago, Chicago, Illinois; and ##Rollins School of Public Health, Emory University, Atlanta, Georgia.
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  • Thomas R. Prohaska PhD,

    1. From the *Department of Psychiatry and Behavioral Sciences, School of Medicine, Health Promotion Research Center, School of Nursing, University of Washington, Seattle, Washington; §Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; **Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, #National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; ††Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina; ‡‡Michigan Department of Community Health, Lansing, Michigan; §§Center for Stroke Research, Center for Cognitive Medicine; University of Illinois Medical Center at Chicago, Chicago, Illinois; and ##Rollins School of Public Health, Emory University, Atlanta, Georgia.
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  • David J. Thurman MD, MPH,

    1. From the *Department of Psychiatry and Behavioral Sciences, School of Medicine, Health Promotion Research Center, School of Nursing, University of Washington, Seattle, Washington; §Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; **Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, #National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; ††Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina; ‡‡Michigan Department of Community Health, Lansing, Michigan; §§Center for Stroke Research, Center for Cognitive Medicine; University of Illinois Medical Center at Chicago, Chicago, Illinois; and ##Rollins School of Public Health, Emory University, Atlanta, Georgia.
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  • David R. Brown PhD,

    1. From the *Department of Psychiatry and Behavioral Sciences, School of Medicine, Health Promotion Research Center, School of Nursing, University of Washington, Seattle, Washington; §Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; **Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, #National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; ††Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina; ‡‡Michigan Department of Community Health, Lansing, Michigan; §§Center for Stroke Research, Center for Cognitive Medicine; University of Illinois Medical Center at Chicago, Chicago, Illinois; and ##Rollins School of Public Health, Emory University, Atlanta, Georgia.
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  • James N. Laditka DA, PhD,

    1. From the *Department of Psychiatry and Behavioral Sciences, School of Medicine, Health Promotion Research Center, School of Nursing, University of Washington, Seattle, Washington; §Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; **Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, #National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; ††Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina; ‡‡Michigan Department of Community Health, Lansing, Michigan; §§Center for Stroke Research, Center for Cognitive Medicine; University of Illinois Medical Center at Chicago, Chicago, Illinois; and ##Rollins School of Public Health, Emory University, Atlanta, Georgia.
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  • Jesus Soares ScD,

    1. From the *Department of Psychiatry and Behavioral Sciences, School of Medicine, Health Promotion Research Center, School of Nursing, University of Washington, Seattle, Washington; §Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; **Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, #National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; ††Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina; ‡‡Michigan Department of Community Health, Lansing, Michigan; §§Center for Stroke Research, Center for Cognitive Medicine; University of Illinois Medical Center at Chicago, Chicago, Illinois; and ##Rollins School of Public Health, Emory University, Atlanta, Georgia.
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  • Damita J. Zweiback DPA,

    1. From the *Department of Psychiatry and Behavioral Sciences, School of Medicine, Health Promotion Research Center, School of Nursing, University of Washington, Seattle, Washington; §Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; **Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, #National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; ††Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina; ‡‡Michigan Department of Community Health, Lansing, Michigan; §§Center for Stroke Research, Center for Cognitive Medicine; University of Illinois Medical Center at Chicago, Chicago, Illinois; and ##Rollins School of Public Health, Emory University, Atlanta, Georgia.
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  • Deborah Little PhD,

    1. From the *Department of Psychiatry and Behavioral Sciences, School of Medicine, Health Promotion Research Center, School of Nursing, University of Washington, Seattle, Washington; §Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; **Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, #National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; ††Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina; ‡‡Michigan Department of Community Health, Lansing, Michigan; §§Center for Stroke Research, Center for Cognitive Medicine; University of Illinois Medical Center at Chicago, Chicago, Illinois; and ##Rollins School of Public Health, Emory University, Atlanta, Georgia.
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  • Lynda A. Anderson PhD

    1. From the *Department of Psychiatry and Behavioral Sciences, School of Medicine, Health Promotion Research Center, School of Nursing, University of Washington, Seattle, Washington; §Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; **Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, #National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; ††Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina; ‡‡Michigan Department of Community Health, Lansing, Michigan; §§Center for Stroke Research, Center for Cognitive Medicine; University of Illinois Medical Center at Chicago, Chicago, Illinois; and ##Rollins School of Public Health, Emory University, Atlanta, Georgia.
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Address correspondence to Mark Snowden, University of Washington, Box 359911, Seattle, WA 98104. E-mail: snowden@u.washington.edu

Abstract

There is evidence from observational studies that increasing physical activity may reduce the risk of cognitive decline in older adults. Exercise intervention trials have found conflicting results. A systematic review of physical activity and exercise intervention trials on cognition in older adults was conducted. Six scientific databases and reference lists of previous reviews were searched. Thirty studies were eligible for inclusion. Articles were grouped into intervention–outcome pairings. Interventions were grouped as cardiorespiratory, strength, and multicomponent exercises. Cognitive outcomes were general cognition, executive function, memory, reaction time, attention, cognitive processing, visuospatial, and language. An eight-member multidisciplinary panel rated the quality and effectiveness of each pairing. Although there were some positive studies, the panel did not find sufficient evidence that physical activity or exercise improved cognition in older adults. Future research should report exercise adherence, use longer study durations, and determine the clinical relevance of measures used.

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