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Exercise is Medicine for the Aging Brain

Teresa Liu-Ambrose and John R. Best

Cognitive decline is a common feature of aging. Physical activity is a modifiable lifestyle factor that has been identified as positively impacting cognitive health of older adults. Here, we review the current evidence from epidemiological (i.e., longitudinal cohort) and intervention studies on the role of physical activity and exercise in promoting cognitive health in older adults both with and without cognitive impairment. We highlight some of the potential underlying mechanisms and discuss some of the potential modifying factors, including exercise type and target population, by reviewing recent converging behavioral, neuroimaging, and biomarker evidence linking physical activity with cognitive health. We conclude with limitations and future directions for this rapidly expanding line of research.

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The Effects of Physical Activity and Fitness in Adolescence on Cognition in Adulthood and the Role of Insulin-Like Growth Factor I

Doeschka A. Ferro, Jan Berend Deijen, Lando L. Koppes, Willem van Mechelen, Jos W. Twisk, and Madeleine L. Drent


Physical activity and fitness in adolescence may improve cognition in adulthood by increasing insulin-like growth factor I (IGF-I).


As part of the Amsterdam Growth and Health Longitudinal Study, following subjects from age 13 to 42 years, physical activity and fitness of 303 subjects were assessed annually between the ages 13 to 16. At mean age 36, physical activity, fitness and IGF-I were measured. At mean age 42, IGF-I and cognitive factors (ie, executive functioning and visual-spatial memory) were measured. The linear regression of physical activity and fitness in adolescence and IGF-I in adulthood on cognitive scores in adulthood was investigated.


A significant association was found in males between physical activity in adolescence and executive function in adulthood (Spatial Working Memory Between Errors: β = –.18, B = –.13, 95% CI = –.259 to –.010; Spatial Working Memory Strategy: β = –.20, B = –.08, 95% CI = –.147 to –.014). No association between physical activity or fitness in adolescence and cognitive function in adulthood was found in females, nor any intermediate role for IGF-I in either sex.


The results suggest a stimulating effect of adolescent physical activity in males on executive functions in adulthood, emphasizing the importance of an active lifestyle among adolescent males.

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Protective Role of Recent and Past Long-Term Physical Activity on Age-Related Cognitive Decline: The Moderating Effect of Sex

Iréné Lopez-Fontana, Carole Castanier, Christine Le Scanff, and Alexandra Perrot

activity to education . Trends in Neuroscience & Education, 5 ( 1 ), 12 – 19 . doi:10.1016/j.tine.2016.02.001 10.1016/j.tine.2016.02.001 Gow , A.J. , Pattie , A. , & Deary , I.J. ( 2017 ). Lifecourse activity participation from early, mid, and later adulthood as determinants of cognitive aging

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Attitudes Toward Physical Activity and Exercise: Comparison of Memory Clinic Patients and Their Caregivers and Prediction of Activity Levels

Megan E. O’Connell, Vanina Dal Bello-Haas, Margaret Crossley, and Debra G. Morgan

Regular physical activity and exercise (PA&E) reduces cognitive aging, may delay dementia onset, and for persons with dementia, may slow progression and improve quality of life. Memory clinic patients and caregivers described their PA&E and completed the Older Persons’ Attitudes Toward Physical Activity and Exercise Questionnaire (OPAPAEQ). Caregivers and patients differed in their PA&E attitudes: patients were less likely to believe in the importance of PA&E for health promotion. PA&E attitudes were explored as predictors of self-reported exercise habits. Belief in the importance of high intensity exercise for health maintenance was the only variable that significantly predicted engagement in regular PA&E. Moreover, caregivers’ attitudes toward high intensity exercise predicted memory patients’ participation in PA&E. These findings may aid in development of exercise interventions for people with memory problems, and suggest that modification of specific attitudes toward exercise is an important component to ensure maximum participation and engagement in PA&E.

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Healthy Active Aging Can Help Urban Populations Be More Resilient to Changing Environments

Ruth F. Hunter and Ione Avila-Palencia

environment (such as crime and safety, social disadvantage, social capital, disorder, and civic participation) encompass social relationships, which impact cognitive aging by influencing loneliness, social support, social networks, and social interactions. 10 Evidence-informed, health-oriented urban design is

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Higher Cardiorespiratory Fitness Is Associated With Better Verbal Generativity in Community-Dwelling Older Adults

Natalie Frost, Michael Weinborn, Gilles E. Gignac, Shaun Markovic, Stephanie R. Rainey-Smith, Hamid R. Sohrabi, Ralph N. Martins, Jeremiah J. Peiffer, and Belinda M. Brown

et al., 2009 ). As executive functions are predominantly frontal lobe processes, they are particularly vulnerable to age-related decline, with cognitive deficits in this domain recognized as one of the first markers of cognitive aging and decline ( Buckner, 2004 ; Pfefferbaum, Adalsteinsson

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Sitting Time, Physical Activity, and Cognitive Impairment in Midlife and Older Adults

Tal Gafni, Kerem Shuval, Galit Weinstein, Carolyn E. Barlow, Kelley Pettee Gabriel, Benjamin L. Willis, David Leonard, William L. Haskell, and Laura F. DeFina

exponentially with age, particularly above the age of 75 years ( World Health Organization, 2015 ), cognitive aging may start as early as in the third and fourth decades of life, due to structural and functional brain changes ( Harada, Love, & Triebel, 2013 ; Salthouse, 2009 ). These changes primarily affect

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Self-Paced Cycling Improves Cognition on Institutionalized Older Adults Without Known Cognitive Impairment: A 15-Month Randomized Controlled Trial

Silvia Varela, José M. Cancela, Manuel Seijo-Martinez, and Carlos Ayán

successful cognitive aging . Journal of the American Academy of PAs, 30 ( 8 ), 30 – 35 . Covinsky , K.E. , Eng , C. , Lui , L.-Y. , Sands , L.P. , & Yaffe , K. ( 2003 ). The last 2 years of life: Functional trajectories of frail older people . Journal of the American Geriatrics Society, 51

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The Acute Effects of Different Exercise Intensities on Associative Novel Word Learning in Healthy Older Adults: A Randomized Controlled Trial

Marie-Pier McSween, Katie L. McMahon, Kylie Maguire, Jeff S. Coombes, Amy D. Rodriguez, Kirk I. Erickson, and David A. Copland

cognitive aging and delay normal age-related cognitive decline. Acute physical exercise has received increasing interest for its potential to benefit cognitive functions ( Abe, Fujii, Hyodo, Kitano, & Okura, 2018 ; Chang, Labban, Gapin, & Etnier, 2012 ; Etnier et al., 2016 ). Exercise benefits on

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The Relations Between Physical Activity Level, Executive Function, and White Matter Microstructure in Older Adults

Marissa A. Gogniat, Catherine M. Mewborn, Talia L. Robinson, Kharine R. Jean, and L. Stephen Miller

K . Normal Cognitive Aging . Clin Geriatr Med . 2013 ; 29 : 737 – 752 . doi:10.1016/j.cger.2013.07.002 10.1016/j.cger.2013.07.002 24094294 6. Salthouse TA . Selective review of cognitive aging . J Int Neuropsychol Soc . 2010 ; 16 : 754 – 760 . doi:10.1017/S1355617710000706 10.1017/S