Physical activity for older Australians with mild cognitive impairment or subjective cognitive decline - A narrative review to support guideline development

Terence W H Chong; Eleanor Curran; Kathryn A Ellis; Jenny Southam; Emily You; Kay L Cox; Keith D Hill; Dimity Pond; Briony Dow; Kaarin J Anstey; Diane Hosking; Elizabeth Cyarto; Nicola T Lautenschlager

doi:10.1016/j.jsams.2020.03.003

Physical activity for older Australians with mild cognitive impairment or subjective cognitive decline - A narrative review to support guideline development

J Sci Med Sport. 2020 Oct;23(10):913-920. doi: 10.1016/j.jsams.2020.03.003. Epub 2020 Mar 19.

Authors

Affiliations

¹ Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Australia; St Vincent's Hospital Melbourne, Department of Psychiatry, The University of Melbourne, Australia; Epworth Healthcare, Australia; North Western Mental Health, Melbourne Health, Australia. Electronic address: twhc@unimelb.edu.au.
² Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Australia; North Western Mental Health, Melbourne Health, Australia.
³ Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Australia.
⁴ Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Australia.
⁵ Medical School, Royal Perth Hospital Unit, University of Western Australia, Australia.
⁶ Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Australia.
⁷ University of Newcastle, Australia.
⁸ National Ageing Research Institute, The University of Melbourne, Australia.
⁹ University of New South Wales, Australia; Neuroscience Research Australia, Australia.
¹⁰ Centre of Excellence in Population Ageing Research, University of New South Wales, Australia; National Seniors Australia, Research, Australia.
¹¹ Bolton Clarke Research Institute, Australia.
¹² Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Australia; North Western Mental Health, Melbourne Health, Australia; Division of Psychiatry and WA Centre for Health and Ageing, University of Western Australia, Australia.

PMID: 32389610
DOI: 10.1016/j.jsams.2020.03.003

Abstract

Objectives: This review informed development of the first national Physical Activity (PA) Guidelines for Older Australians with Mild Cognitive Impairment (MCI) or Subjective Cognitive Decline (SCD) (http://www.dementiaresearch.org.au/images/dcrc/output-files/1567-pa_guidelines_for_mci_or_scd_full_report_final.pdf). These guidelines are directed at healthcare professionals and aim to encourage older adults with SCD/MCI to engage in PA to enhance cognitive, mental and physical health.

Design: A narrative review was undertaken to inform the guideline adaptation process.

Methods: A systematic search of existing PA guidelines for older adults was performed and evaluated using the Appraisal of Guidelines for Research and Evaluation II Instrument. The guideline assessed as most appropriate was adapted to the population with SCD/MCI using the Guideline Adaptation Resource Toolkit, supported by the narrative review.

Results: The search for existing PA guidelines for older adults yielded 22 guidelines, none of which specifically considered older adults with SCD/MCI. The Canadian Physical Activity Guidelines for Older Adults were selected for adaptation to the population with SCD/MCI. The narrative review found 24 high-quality randomised controlled trials and 17 observational studies. These supported the four guideline recommendations that address aerobic PA, progressive resistance training, balance exercises and consultation with healthcare professionals to tailor PA to the individual.

Conclusions: This review found evidence to support the four guideline recommendations. These recommendations provide specific guidance for older adults with SCD/MCI, their families, health professionals, community organisations and government to obtain benefits from undertaking PA. The review also highlights important future research directions, including the need for targeted translation and implementation research for diverse consumers.

Keywords: Cognition; Exercise; Guidelines; Mild Cognitive Impairment; Physical activity; Subjective Cognitive Decline.

Publication types

Review

MeSH terms

Australia
Cognitive Dysfunction / therapy*
Exercise Therapy*
Exercise*
Guidelines as Topic
Humans
Middle Aged