This paper provides a systematic review of current research findings using exergaming as a treatment for improving cognition and dual-task function in older adults. A literature search was conducted to collect exergaming intervention studies that were either randomized controlled or uncontrolled studies. Of the seven identified studies (five randomized controlled studies and two uncontrolled studies), three studies focused on cognitive function alone, two studies focused on dual-task function alone, and two studies measured both cognitive function and dual-task function. Current evidence supports that exergaming improves cognitive function and dual-task function, which potentially leads to fall prevention. However, it is unclear whether exergaming, which involves both cognitive input and physical exercise, has additional benefits compared with traditional physical exercise alone. Further studies should include traditional exercise as a control group to identify these potential, additional benefits.
Elisa F. Ogawa, Tongjian You and Suzanne G. Leveille
Milan Chang, Suzanne Leveille, Jiska Cohen-Mansfield and Jack M. Guralnik
The Hebrew Home Study of Impairment and Exercise is a cross-sectional community-based study of nondisabled adults age 75–85 years that assessed attitude toward exercise by asking level of agreement with four statements evaluating participants’ perceptions of the health benefits and personal rewards of exercise. A physical-performance battery evaluated lower extremity function on a scale of 0 to 12. Attitude toward exercise was compared across 4 groups: non-vigorous exercisers with scores of 4–6 (n = 21), 7–9 (n = 90), or 10–12 (n = 113) and vigorous exercisers (n = 71). Vigorous exercisers had a significantly better attitude toward exercise than the reference group did, with odds ratios of 1.8-5.5 in all attitude statements. The lowest and moderate-performance groups had less positive attitudes toward exercise than the reference group did, with odds ratios of 0.27–0.62 for all statements. There was a highly significant gradient with better attitude toward exercise and higher functional-status level. Future work in improving older adults’ compliance with exercise should take into account the less positive attitude of those with functional limitations toward the benefits of exercise.
Suzanne G. Leveille, Jiska Cohen-Mansfield and Jack M. Guralnik
The authors examined the relationship between musculoskeletal pain, self-efficacy, attitudes and beliefs about exercise, and physical activity in 75- to 85-year-old adults. Participants rated their pain during the preceding month in their back, hips, knees, and feet on a scale of 0 to 10. Pain was categorized by number of sites of moderate to severe pain. Among the 325 participants, 42.8% reported at least moderate pain in at least 1 site. Having more pain sites was associated with younger age, lower income, depressed mood, and poorer self-rated health. Participants with more pain sites scored lower on exercise attitudes, beliefs, and self-efficacy, but the self-efficacy scale was most strongly associated with physical activity. Participants with 2–4 pain sites and low self-efficacy were >4 times as likely to be sedentary as those with no pain and high self-efficacy. These findings suggest that improving self-efficacy for exercise might be an important component of programs to increase physical activity in adults with chronic musculoskeletal pain.
Jack M. Guralnik, Suzanne Leveille, Stefano Volpato, Marcia S. Marx and Jiska Cohen-Mansfield
Epidemiological studies have demonstrated that, using objective performance measures of physical functioning, disability risk can be predicted in nondisabled older adults. This makes it possible to recruit a nondisabled but at-risk population for clinical trials of disability prevention. Successful disability prevention in this population, for example through an exercise program, would have a major public health impact. To enhance the development of exercise interventions in this group it would be valuable to have additional information not available from existing epidemiologic studies. This report examines the evidence that functional limitations preceding disability can be identified in a community-dwelling population and that it is feasible to recruit these people into studies. It introduces a series of articles examining the characteristics of this population: motivators and barriers to exercise, exercise habits and preferences, the impact of positive and negative affect, and the impact of pain and functional limitations on attitudes toward exercise.
Glenn V. Ostir, Jiska Cohen-Mansfield, Suzanne Leveille, Stefano Volpato and Jack M. Guralnik
This study investigated whether positive or negative affect has an independent association with exercise self-efficacy. Participants (N = 324) age 75-85 were classified as high or at-risk performers, and three exercise-self-efficacy items (scored 1-10) were assessed. For at-risk performers, positive affect was significantly associated with confidence in the ability to perform strength and flexibility (b = 0.83, SE = 0.23, p = .001) and aerobic exercise (b = 0.59, SE = 0.28, p = .04) and with the perception that exercise would not worsen preexisting symptoms (b = 0.73, SE = 0.24, p = .001). Among high performers, nonsignificant associations were found for positive and negative affect and exercise-self-efficacy. For at-risk performers, higher positive affect was associated with an increased odds ratio of 2.72 for scoring 10 on the muscle strength and flexibility item, 4.08 on the aerobic item, and 2.94 on the item assessing preexisting symptoms. The results suggest that improving at-risk older adults’ positive affect might increase their participation in exercise.