Effects of physical exercise on the cognition of older adults with frailty syndrome: A systematic review and meta-analysis of randomized trials

• Published in: Archives of gerontology and geriatrics Vol. 93; p. 104322
• Main Authors: Rossi, Paulo Giusti, Carnavale, Bianca Ferdin, Farche, Ana Claudia Silva, Ansai, Juliana Hotta, de Andrade, Larissa Pires, Takahashi, Anielle Cristhine de Medeiros
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-03-2021
• Subjects: Aged; Aging; Cognition; Exercise; Frail Elderly; Frailty; Humans; Meta-analysis; Physical exercise; Randomized Controlled Trials as Topic; Physical exercise; Aging; Frailty; Cognition; Meta-analysis
• ISSN: 0167-4943; 1872-6976
• DOI: 10.1016/j.archger.2020.104322

•Physical exercise promotes benefits in the cognition of older adults with frailty.•The most frequent type of intervention was the multicomponent physical exercise.•Global cognition and domains of sequencing, mental flexibility and visuomotor skills are improved.•The cognitive gains are probably related to the aerobic component of the exercise protocols developed.•The risk of bias indicated good quality in all selected studies.
To analyze the effects of physical exercise on the cognition of community-dwelling older adults with frailty syndrome, through randomized clinical trials.
Articles published until March 2020 were searched in the databases Science Direct, Scopus, Web of Science, PubMed, Lilacs, Cochrane, IEEE, EMBASE, and SciELO. Search terms included frailty, aged, exercise, rehabilitation, and cognition. For the Portuguese language, equivalent terms were used.
Only randomized clinical trials that used physical exercise as an intervention method in community-dwelling older adults (≥ 60y.) with frailty syndrome, and which performed cognitive assessments before and after the intervention were included.
Two authors performed data extraction using predefined data fields. The risk of bias of the six included studies was assessed using the PEDro scale.
In total, 4501 studies were found. After the selection process, 6 studies were included in the systematic review and 4 studies in the meta-analysis, all with a low risk of bias. The studies included 655 community-dwelling older adults with frailty syndrome. The types of intervention varied, with multicomponent physical exercise being the most frequent. The cognitive assessments were diverse, and the Mini-mental State Examination, Trail Making Test forms A and B, and Digit Span test were the most frequently applied. A meta-analysis was performed with Global Cognition and Trail Making Test forms A and B. The data from the meta-analysis showed that physical exercise improves Global Cognition (Mean Difference = 2.26; 95% CI, 0.42 – 4.09; P = 0.02) and mental flexibility (Trail Making Test B) (Mean Difference = -30.45; 95% CI; - 47.72 – -13.19; P = 0.0005).
Interventions with physical exercise promote benefits in global cognition and mental flexibility of older adults with frailty syndrome.