Effects of weight training on cognitive functions in elderly with Alzheimer's disease

Vital, Thays Martins; Hernández, Salma S. Soleman; Pedroso, Renata Valle; Teixeira, Camila Vieira Ligo; Garuffi, Marcelo; Stein, Angelica Miki; Costa, José Luiz Riani; Stella, Florindo

doi:10.1590/S1980-57642012DN06040009

ABSTRACT

Deterioration in cognitive functions is characteristic in Alzheimer's disease (AD) and may be associated with decline in daily living activities with consequent reduced quality of life.

Objective: To analyze weight training effects on cognitive functions in elderly with AD. Subjects: 34 elderly with AD were allocated into two groups: Training Group (TG) and Social Gathering Group (SGG).

Methods: Global cognitive status was determined using the Mini-Mental State Exam. Specific cognitive functions were measured using the Brief Cognitive Battery, Clock Drawing Test and Verbal Fluency Test. The protocols were performed three times a week, one hour per session. The weight training protocol consisted of three sets of 20 repetitions, with two minutes of rest between sets and exercises. The activities proposed for the SGG were not systematized and aimed at promoting social interaction among patients. The statistical analyses were performed with the U Mann Whitney and Wilcoxon tests for group comparisons. All analyses were considered statistically significant at a p-value of 0.05.

Results: There were no significant differences associated to the effects of the practice of weight training on cognition in AD patients.

Conclusion: In this study, no improvement in cognitive functions was evident in elderly with AD who followed a low intensity resistance exercise protocol. Thus, future studies could evaluate the effect of more intense exercise programs.

Key words: cognition; Alzheimer's disease; resistance training

RESUMO.

A deterioração das funções cognitivas é característica na doença de Alzheimer (DA) e se relaciona com uma pior realização das atividades de vida diária levando a uma pior qualidade de vida.

Objetivo: Analisar os efeitos de um programa de treinamento com pesos nas funções cognitivas de idosos com DA. Sujeitos: 34 idosos com DA foram alocados em dois grupos: Grupo Treinamento (GT) e Grupo de Convívio Social (GCS).

Métodos: Para caracterização do perfil cognitivo global utilizou-se o Mini-Exame de Estado Mental. Para a mensuração das funções cognitivas foram utilizadas: Bateria Cognitiva Breve, Teste do Desenho do Relógio e teste de Fluência Verbal. Os protocolos oferecidos foram realizados três vezes na semana, durante uma hora. O protocolo de treinamento do GT consistiu em realizar três séries de 20 repetições para cada exercício, com dois minutos de intervalo entre séries e entre exercícios. As atividades propostas para o GCS não foram sistematizadas e tiveram por objetivo promover uma socialização dos pacientes. A análise estatística consistiu na utilização dos testes U Mann Whitney e Wilcoxon para comparação intra e entre grupos. Adotou-se nível de significância de 5% para todas as análises.

Resultados: Não foram evidenciadas diferenças significativas relacionadas aos efeitos da prática do treinamento com pesos na cognição de idosos com DA.

Conclusão: Neste estudo não houve melhora nas funções cognitivas em idosos com DA que realizaram um protocolo de exercícios resistidos de intensidade leve. Assim, estudos futuros poderiam verificar o efeito de exercícios mais intensos.

Palavras-chave: cognição; doença de Alzheimer; treinamento resistido

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REFERENCES

Braak E, Griffing K, Arai K, et al. Neuropathology of Alzheimer's disease: what is new since A. Alzheimer? Eur Arch Psychiatry Clin Neurosci 1999;49:14-22.
Braak H, Braak E. Neuroanatomy of Alzheimer's desease. Alzheimer's Res 1997;3:235-247.
Braak H, Braak E. Evolution of neuronal changes in the course of Alzheimer's disease. J Neural Transm 1998;53:127-140.
Swerdlow RH. Is aging part of Alzheimer's disease, or is Alzheimer's disease part of aging? Neurobiol Aging 2007;28:1465-1480.
American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 4th ed, Text Revision (DSM-IV-TR). Washington: DC; 2000:943.
Perry RJ, Hodges JR. Relationship between functional and neuropsychological performance in early Alzheimer disease. Alzheimer Dis Assoc Disord 2000;14:1-10.
Aguero-Torres H, Fratiglioni l, Guo Z, et al. Dementia is the major cause of functional dependence in the elderly: 3-year follow-up data from a population based study. Am J Public Health 1998;88:1452-1456.
Nitrini R, Caramelli P, Mansur L, Neuropsicologia: das bases anatômicas à reabilitação. São Paulo: HCFMUSP; 2003.
Andersen CK, Wittup-Jensen KU, Lolk A, et al. Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. Health Qual Life Outcomes 2004;2:52.
Senanarong V, Poungvarin N, Jamjumras P, et al. Neuropsychiatric symptoms, functional impairment and executive ability in Thai patients with Alzheimer's Disease. Int Psychogeriatr 2005;1:81-90.
Lanari A, Amenta F, Sivestrelli G, et al. Neurotransmitter déficits in behavioural and psychological symptoms of Alzheimer's disease. Mech Ageing Dev 2007;127:158-165.
Heyn P. The effect of a multisensory exercise program on engagement, behavior, and selected physiological. Am J Alzheimer's Dis Other Demen 2003;18:247-251.
Liu-Ambrose T, Donaldson MG. Exercise and cognition in older adults: is there a role for resistance training programmes? Br J Sports Med 2009;43:25-27.
Deslandes A, Moraes H, Ferreira C, et al. Exercise and Mental Health: Many Reasons to Move. Neurophycobiology 2009;59:191-198.
Coelho FGM, Santos-Galduroz RF, Gobbi S, Stella F. Atividade física sistematizada e desempenho cognitivo em idosos com demência de Alzheimer: uma revisão sistematizada. Rev Bras Psiquiatr 2009;31: 163-170.
Antunes HKM, Santos RF, Cassilhas R, et al. Exercício físico e função cognitiva: uma revisão. Rev Brás Med Esporte 2006;12:108-114.
Larson, EB, Wang l, Bowen J, et al. Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Ann Int Med 2006;144:73-81.
Kashihara K, Maruyama T, Murota M, Nakahara Y. Positive Effects of Acute and Moderate Physical Exercise on Cognitive Function. J Physiol Anthropol 2009;28:155-164.
Lista I, Sorrentino G. Biological mechanisms of physical activity in preventing cognitive decline. Cell Mol Neurobiol 2009;30:493-503.
Hernandez SSS, Coelho FGM, Gobbi S, Stella, F. Efeitos de um programa de atividade física nas funções cognitivas, equilíbrio e risco de quedas em idosos com demência de Alzheimer. Rev Bras Fisiot 2010;14:68-74.
Teri L, Gibbons LE, Mccurry SM, et al. Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. J Am Med Assoc 2003;290:2015-2022.
Rolland Y, Pillard F, Klapouszczak A, et al. Exercise Program for Nursing Home Residents with Alzheimer's Disease: A 1-Year Randomized, Controlled Trial. J Am Geriatrics Soc 2007;55:158-165.
Arkin S. Student-led exercise sessions yield significant fitness gains for Alzheimer's patients. Am J Alzheimer's Dis Other Demen 2003;18: 159-170.
Aman E, Thomas DR. Supervised Exercise to Reduce Agitation in Severely Cognitively Impaired Persons. J Am Med Dir Assoc 2009;10: 271-276.
Steinberg M, Leoutsakos JS, Podewils LJ, Lyketsos CG. Evaluation of a home-based exercise program in the treatment of Alzheimer's disease: The Maximizing Independence in Dementia (MIND) study. Int J Geriatr Psychiatry 2009;24:680-685.
Arcoverde C, Deslandes A, Rangel A, et al. Role of physical activity on the maintenance of cognition and activities of daily living in elderly with Alzheimer's disease. Arq Neuropsiquiatr 2008;66:323-327.
Perrig-Chiello P, Perrig WJ, Ehrsam R, Staehelin HB, Krings F. The effects of resistance training on well-being and memory in elderly volunteers. Age Ageing 1998;27:469-475.
Özkaya GY, Aydin H, Toraman FN, Kizilay F, Ozdemir O, Cetinkaya V. Effect of strength and endurance training on cognition in older people. J Sports Sci Med 2005;4:300-313.
Cassilhas RC, Viana VA, Grassmann V, et al. The Impact f Resistance Exercise on the Cognitive Function of the Elderly. Med Sci Sport Exerc 2007;39:1401-1407.
Busse AL, Jacob-Filho W, Magaldi RM, et al. Effects of Resistance Training Exercise on Cognitive Performance in Elderly Individuals with Memory Impairment: Results of a Controlled Trial. Einstein 2008;6:402-407.
Garuffi M, Gobbi S , Hernandez SSS , et al. Atividade física para promoção da saúde de idosos com doença de Alzheimer e seus cuidadores. Rev Bras Ativ Fís Saúde 2011;16:80-83.
Morris J. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 1993;43:2412-2414.
Montaño MBMM, Ramos LR. Validade da versão em português da Clinical Dementia Rating (CDR). Rev Saúde Pública 2005;39:912-917.
Voorrips L, Ravelli A, Dongelmans P, Deurenberg P, Van Staveren W. A physical activity questionnaire for elderly. Med Sci Sports Exerc 1991;23: 974-979.
Folstein MF, Folstein SE, Mchugh PR. Mini-mental state. A practical method for grading the cognitive patients for the clinician. J Psychiatry Res 1975;12:189-198.
Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto JH. Suggestions for the utilization of the mini-mental state examination in Brazil. Arq Neuropsiquiatr 2003;61:777-781.
Nitrini R, Lefèvre BH, Mathias SC, et al. Testes neuropsicológicos de aplicação simples para o diagnóstico de demências. Arq Neuropsiquiatr 1994; 52:457-465.
Nitrini R, Caramelli P, Porto CS, et al. Brief cognitive battery in the diagnosis of mild Alzheimer's disease in subjects with medium and high levels of education. Dement Neuropsychol 2007;1:32-36.
Christofoletti G, Oliani MM, Stella F, Gobbi S , Gobbi LTB. Influence of scholarity on cognitive screening test in elderly people. Dement Neuropsychol 2007;1:46-51.
Sunderland T, Hill JL, Mellow AM, et al. Clock drawing in Alzheimer's disease. A novel measure of dementia severity. J Am Geriatrics Soc i 1989;37:725-729.
Lezak MD. Neuropsychological Assessment. 3º ed. New Yourk: Oxford Press; 1995.
Garuffi M , Costa JLR, Hernández SSS, et al. Effects of resistance training on the performance of activities of daily living in patients with Alzheimer's disease. Geriatrics and Gerontology International 2012; Disponível em: 10.1111/j.1447-0594.2012.00899.x. Acesso em 25 de junho de 2012.
Busse AL, Gil G, Santarém JM, Filho WJ. Physical activity and cognition in the elderly. Dement Neuropsychol 2009;3:204-208.
Lachman ME, Neupert SD, Bertrand R, Jette AM. The effects of strength training on memory in older adults. J Aging Physl Act 2006;14:59-73.
Liu-Ambrose T, Donaldson MG, Ahamed Y, et al. Otago home-based strength and balance retraining improves executive functioning in older fallers: a randomized controlled trial. J Am Geriatr Soc 2008;56: 821-830.
Thomas VS, Hageman PA. Can neuromuscular strength and function in people with dementia be rehabilitated using resistance-exercise training? Results from a preliminary intervention study. J Gerontol Med Sci 2003; 58A:746-751.
Hurley BF, Hanson ED, Sheaff AK. Strength training as a countermeasure to aging muscle and chronic disease. Sports Med 2011;41:289-306.

Publication Dates

Publication in this collection
Oct-Dec 2012

History

Received
04 June 2012
Accepted
18 Aug 2012

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] Braak E, Griffing K, Arai K, et al. Neuropathology of Alzheimer's disease: what is new since A. Alzheimer? Eur Arch Psychiatry Clin Neurosci 1999;49:14-22.

[2] Braak H, Braak E. Neuroanatomy of Alzheimer's desease. Alzheimer's Res 1997;3:235-247.

[3] Braak H, Braak E. Evolution of neuronal changes in the course of Alzheimer's disease. J Neural Transm 1998;53:127-140.

[4] Swerdlow RH. Is aging part of Alzheimer's disease, or is Alzheimer's disease part of aging? Neurobiol Aging 2007;28:1465-1480.

[5] American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 4th ed, Text Revision (DSM-IV-TR). Washington: DC; 2000:943.

[6] Perry RJ, Hodges JR. Relationship between functional and neuropsychological performance in early Alzheimer disease. Alzheimer Dis Assoc Disord 2000;14:1-10.

[7] Aguero-Torres H, Fratiglioni l, Guo Z, et al. Dementia is the major cause of functional dependence in the elderly: 3-year follow-up data from a population based study. Am J Public Health 1998;88:1452-1456.

[8] Nitrini R, Caramelli P, Mansur L, Neuropsicologia: das bases anatômicas à reabilitação. São Paulo: HCFMUSP; 2003.

[9] Andersen CK, Wittup-Jensen KU, Lolk A, et al. Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. Health Qual Life Outcomes 2004;2:52.

[10] Senanarong V, Poungvarin N, Jamjumras P, et al. Neuropsychiatric symptoms, functional impairment and executive ability in Thai patients with Alzheimer's Disease. Int Psychogeriatr 2005;1:81-90.

[11] Lanari A, Amenta F, Sivestrelli G, et al. Neurotransmitter déficits in behavioural and psychological symptoms of Alzheimer's disease. Mech Ageing Dev 2007;127:158-165.

[12] Heyn P. The effect of a multisensory exercise program on engagement, behavior, and selected physiological. Am J Alzheimer's Dis Other Demen 2003;18:247-251.

[13] Liu-Ambrose T, Donaldson MG. Exercise and cognition in older adults: is there a role for resistance training programmes? Br J Sports Med 2009;43:25-27.

[14] Deslandes A, Moraes H, Ferreira C, et al. Exercise and Mental Health: Many Reasons to Move. Neurophycobiology 2009;59:191-198.

[15] Coelho FGM, Santos-Galduroz RF, Gobbi S, Stella F. Atividade física sistematizada e desempenho cognitivo em idosos com demência de Alzheimer: uma revisão sistematizada. Rev Bras Psiquiatr 2009;31: 163-170.

[16] Antunes HKM, Santos RF, Cassilhas R, et al. Exercício físico e função cognitiva: uma revisão. Rev Brás Med Esporte 2006;12:108-114.

[17] Larson, EB, Wang l, Bowen J, et al. Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Ann Int Med 2006;144:73-81.

[18] Kashihara K, Maruyama T, Murota M, Nakahara Y. Positive Effects of Acute and Moderate Physical Exercise on Cognitive Function. J Physiol Anthropol 2009;28:155-164.

[19] Lista I, Sorrentino G. Biological mechanisms of physical activity in preventing cognitive decline. Cell Mol Neurobiol 2009;30:493-503.

[20] Hernandez SSS, Coelho FGM, Gobbi S, Stella, F. Efeitos de um programa de atividade física nas funções cognitivas, equilíbrio e risco de quedas em idosos com demência de Alzheimer. Rev Bras Fisiot 2010;14:68-74.

[21] Teri L, Gibbons LE, Mccurry SM, et al. Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. J Am Med Assoc 2003;290:2015-2022.

[22] Rolland Y, Pillard F, Klapouszczak A, et al. Exercise Program for Nursing Home Residents with Alzheimer's Disease: A 1-Year Randomized, Controlled Trial. J Am Geriatrics Soc 2007;55:158-165.

[23] Arkin S. Student-led exercise sessions yield significant fitness gains for Alzheimer's patients. Am J Alzheimer's Dis Other Demen 2003;18: 159-170.

[24] Aman E, Thomas DR. Supervised Exercise to Reduce Agitation in Severely Cognitively Impaired Persons. J Am Med Dir Assoc 2009;10: 271-276.

[25] Steinberg M, Leoutsakos JS, Podewils LJ, Lyketsos CG. Evaluation of a home-based exercise program in the treatment of Alzheimer's disease: The Maximizing Independence in Dementia (MIND) study. Int J Geriatr Psychiatry 2009;24:680-685.

[26] Arcoverde C, Deslandes A, Rangel A, et al. Role of physical activity on the maintenance of cognition and activities of daily living in elderly with Alzheimer's disease. Arq Neuropsiquiatr 2008;66:323-327.

[27] Perrig-Chiello P, Perrig WJ, Ehrsam R, Staehelin HB, Krings F. The effects of resistance training on well-being and memory in elderly volunteers. Age Ageing 1998;27:469-475.

[28] Özkaya GY, Aydin H, Toraman FN, Kizilay F, Ozdemir O, Cetinkaya V. Effect of strength and endurance training on cognition in older people. J Sports Sci Med 2005;4:300-313.

[29] Cassilhas RC, Viana VA, Grassmann V, et al. The Impact f Resistance Exercise on the Cognitive Function of the Elderly. Med Sci Sport Exerc 2007;39:1401-1407.

[30] Busse AL, Jacob-Filho W, Magaldi RM, et al. Effects of Resistance Training Exercise on Cognitive Performance in Elderly Individuals with Memory Impairment: Results of a Controlled Trial. Einstein 2008;6:402-407.

[31] Garuffi M, Gobbi S , Hernandez SSS , et al. Atividade física para promoção da saúde de idosos com doença de Alzheimer e seus cuidadores. Rev Bras Ativ Fís Saúde 2011;16:80-83.

[32] Morris J. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 1993;43:2412-2414.

[33] Montaño MBMM, Ramos LR. Validade da versão em português da Clinical Dementia Rating (CDR). Rev Saúde Pública 2005;39:912-917.

[34] Voorrips L, Ravelli A, Dongelmans P, Deurenberg P, Van Staveren W. A physical activity questionnaire for elderly. Med Sci Sports Exerc 1991;23: 974-979.

[35] Folstein MF, Folstein SE, Mchugh PR. Mini-mental state. A practical method for grading the cognitive patients for the clinician. J Psychiatry Res 1975;12:189-198.

[36] Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto JH. Suggestions for the utilization of the mini-mental state examination in Brazil. Arq Neuropsiquiatr 2003;61:777-781.

[37] Nitrini R, Lefèvre BH, Mathias SC, et al. Testes neuropsicológicos de aplicação simples para o diagnóstico de demências. Arq Neuropsiquiatr 1994; 52:457-465.

[38] Nitrini R, Caramelli P, Porto CS, et al. Brief cognitive battery in the diagnosis of mild Alzheimer's disease in subjects with medium and high levels of education. Dement Neuropsychol 2007;1:32-36.

[39] Christofoletti G, Oliani MM, Stella F, Gobbi S , Gobbi LTB. Influence of scholarity on cognitive screening test in elderly people. Dement Neuropsychol 2007;1:46-51.

[40] Sunderland T, Hill JL, Mellow AM, et al. Clock drawing in Alzheimer's disease. A novel measure of dementia severity. J Am Geriatrics Soc i 1989;37:725-729.

[41] Lezak MD. Neuropsychological Assessment. 3º ed. New Yourk: Oxford Press; 1995.

[42] Garuffi M , Costa JLR, Hernández SSS, et al. Effects of resistance training on the performance of activities of daily living in patients with Alzheimer's disease. Geriatrics and Gerontology International 2012; Disponível em: 10.1111/j.1447-0594.2012.00899.x. Acesso em 25 de junho de 2012.

[43] Busse AL, Gil G, Santarém JM, Filho WJ. Physical activity and cognition in the elderly. Dement Neuropsychol 2009;3:204-208.

[44] Lachman ME, Neupert SD, Bertrand R, Jette AM. The effects of strength training on memory in older adults. J Aging Physl Act 2006;14:59-73.

[45] Liu-Ambrose T, Donaldson MG, Ahamed Y, et al. Otago home-based strength and balance retraining improves executive functioning in older fallers: a randomized controlled trial. J Am Geriatr Soc 2008;56: 821-830.

[46] Thomas VS, Hageman PA. Can neuromuscular strength and function in people with dementia be rehabilitated using resistance-exercise training? Results from a preliminary intervention study. J Gerontol Med Sci 2003; 58A:746-751.

[47] Hurley BF, Hanson ED, Sheaff AK. Strength training as a countermeasure to aging muscle and chronic disease. Sports Med 2011;41:289-306.