Selam-Kristen-Kat-Kelli

Improved Cognitive Function through Activity in Older Adults : 

Improved Cognitive Function through Activity in Older Adults Creighton University, School of Nursing Kristen Cochran, Selam Ghiday, Kelli Roberts, Kathryn Thompson

Slide 2: 

Problem Statement Older adults over 50 years old are at risk for impaired cognitive function. Scope of the Problem 5.3 million Americans are living with Alzheimer’s Disease1 Every 70 seconds someone will be diagnosed with Alzheimer’s Disease1 Alzheimer’s Disease was the seventh-leading cause of death (2006)1 Fifth-leading cause in death for individuals over 65 years old1 Global cost: $604 billion in 20101 Spending will increase approximately 600% between now and 20501

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Source: Alzheimer’s Association 2011 Alzheimer’s Disease Facts and Figures.

Are there solutions? : 

Are there solutions?

PICO Statement : 

Adults over the age of fifty who participate in physical activity compared to those with a sedentary lifestyle will demonstrate improved or maintained cognitive function measured by various cognitive assessments. PICO Statement

Outcomes : 

Adults over age 50 will participate in physical activity programs at least three times per week to maintain and/or enhance cognition Adults over age 50 will demonstrate improved cognition within 6 months of increased participation in physical activity Fewer adults over age 50 will require treatment for cognitive impairment thereby reducing healthcare costs Outcomes

Summary/Synthesis : 

Summary/Synthesis

Brief description of sample : 

Sample size: 120-2,263 Gender: Male & female Age: Over age 50 Health status: Healthy, normal baseline cognitive function, stable physical activity Mental status: Normal baseline cognitive function, varying levels of education Location: Italy, Australia, Hawaii, & Maryland Setting: Outpatient4,5,6 & inpatient3 Brief description of sample

Summary of synthesized findings : 

All 4 studies’ preliminary results consistently support the notion that physical activity benefits cognitive function; i.e., benefits (from neurologic stimulation) are detected beyond effects from baseline mental status/IQ/educational level (cognitive stimulation) Suggested effects of physical activity include: Positively benefits brain structures associated with executive function4 Improves delayed recall and Alzheimer’s Disease Assessment Scale (ADAS) cognitive scores3 Reduces risk for onset of dementia and Alzheimer’s Disease6 Reduces risk for vascular dementia5 Summary of synthesized findings

Level of Research Evidence : 

Combination of level II and level IV qualities of evidence2: Level II evidence 1 randomized controlled trial (RCT) research study3 Level IV evidence 3 non-experimental designs4,5,6 Level of Research Evidence

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Institutional review board (IRB) approval & written consent All 4 studies Validity & reliability provided 2 studies3,4 Internal & external threats to validity Threat of history 3 studies3,5,6 Threat of maturation 2 studies5,6 Threat of testing 3 studies3,4,5 Threat of selection bias 2 studies4,5 Threat of selection effects 2 studies4,5 3 of 4 studies have non-experimental designs4,5,6 Only 1 study is a randomized control trial (RCT)3 Limited generalizability Quality of Research EvidenceModerate Quality of Evidence

Practice Implications : 

The 4 articles suggest physically active lifestyles are beneficial for adults over age 50 Physical activity programs should target older adults to promote cognitive improvements and better quality of life Implications are supported by moderate quality of evidence Practice Implications

Level of Research Support : 

Results extend findings by Kramer et al. and the Surgeon General4 Results extend findings by Colcombe et al. that attest neurologic benefits result from increased blood flow and perfusion to the brain induced by physical activity3,4 Level of Research Support

Future Research Recommendations : 

Clinical trials should provide the following information: Test the degree (volume and intensity) of cardiovascular demand needed to achieve cognitive benefits4,5 Confirm that physical activity reduces dementia6 Neuroimaging information related to detecting abnormal cognitive functioning should be gathered by a uniform, reputable source such as MRI documentation3,5 Study designs should establish a causal relationship and a follow-up period greater than 4 years5 Future Research Recommendations

Research Recommendation Support : 

Researchers consistently recommend physical activity should be more accurately measured by means of intensity and volume of cardiovascular demands4,5 Findings are consistent among researchers regarding the need for high quality neuroimaging information sources3,5 Research Recommendation Support

Research recommendations’ impact on outcomes : 

Determining the precise degree of physical activity needed for cognitive benefits will enhance cognitive improvements and extend decreased healthcare costs. Research recommendations’ impact on outcomes

References : 

1. Alzheimer's Association. Alzheimer's Association- Home. Retrieved October 23, 2011, from http://www.alz.org 2. LoBiondo-Wood, G., & Haber, J. (2010). Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice. St. Louis, MO: Elsevier. 3. Lautenschlager, N., Cox, K., Flicker, L., Bockxmeer, F., Xiao, J., Greenop, K., Almeida, O. (2008). Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease, JAMA 300(9), 1027-1037. Retrieved from http://www.jama.ama-assn.org 4. Bixby, W. R., Spalding, T. W., Haufler, A. J., Deeny, S. P., Mahlow, P. T., Zimmerman, J. B., Hatfield, B. D. (2007). The unique relation of physical activity to executive function in older men and women. Medicine and Science in Sports and Exercise, 39, 1408-1416. doi: 10.1249/mss.0b013e31806ad708 5. Ravaglia, G., Forti, P., Lucicesare, A., Pisacane, N., Rietti, E., Bianchin, M., & Dalmonte, E. (2008). Physical activity and dementia risk in the elderly: findings from a prospective Italian study. Neurology, 70(19), 1786-1794. doi: 10.1212/01.wnl.0000296276.50595.86 6. Taaffe, D., Irie, F., Masaki, K.H., Abbott, R.D., Petrovitch, H., Webster Ross, G., & White, L.R. (2008). Physical activity, physical function, and incident dementia in elderly men: The Honolulu-Asia aging study. Journal of Gerontology, 63A, 529-535. Retrieved from http://biomedgerontology.oxfordjournals.org/content/63/5/529. abstract References