129
17 (6,391). 65+ years.
21 trials.
Conn et al (2003) (235)
Cyarto et al (20004) (142)
Colcombe and 18 RCTs and quasi Kramer (2003) RCTs. (140) Age 55–80 years.
Not specified.
Bean et al 2004 (139)
Community-dwelling.
General population of older people and older people with chronic disease.
Community, primary healthcare.
General population of older people and older people with chronic disease.
Community, primary healthcare.
General population of older people.
Community-dwelling.
General population and older people with chronic disease.
Community-dwelling.
Mean age 55+ years. General population of older 11 RCTs. people.
Angevaren et al (2008) (138)
Medical and disablement outcomes, self efficacy and Quality of Life (QoL).
Aerobic capacity test. Cardiovascular fitness linked to cognitive function (speed) including motor function, auditory attention and delayed memory.
Outcomes
Exercise has therapeutic effects for almost all community-dwelling older adults including reduction in morbidity and mortality, and enhanced physiologic capacity, leading to improvement in overall function but relationship between function and impairment is nonlinear. A threshold exists after which enhancement in impairment (e.g. strength) will not increase function.
Largest effects on cognitive function were found on motor function, auditory attention and delayed memory (effect size 1.17, 0.52, 0.5) only moderate effects for cognitive speed (0.26) and visual attention (0.26). Intensity rather than duration of exercise determines benefit for cognition. Majority of comparisons yielded NS effects.
Main findings and authors conclusions
No search strategy. Recommendations for exercise given for specific disease. Generally 2–3 times week PRT and aerobic training at 13–17 on the Borg scale of perceived exertion. Improvement in impairment and function don’t always lead to decreased disability. AQS=1/9
Cochrane Review. Difficult to conclude if effects are due to cardiovascular exercise alone or could be achieved with other types of exercise i.e. balance, power and strength exercise. AQS=9/11
AMSTAR Quality score (AQS) comments/ limitations
Aerobic fitness and combination strength training.
Physical activity interventions and progressive resistance training.
VO2 max and cognitive process (speed, visio-spatial, controlled processing and executive control).
Functional tasks and strength measures.
Aerobic training had robust but selective benefits on cognition process particularly for executive control process (tasks relating to planning, inhibition and scheduling of mental procedures).
Increased strength reported but further population-based studies including home and whole community interventions are required.
Complex coding system used to categorise results but unclear explanation and no quality score for trials. AQS=3/11
Paucity of strong evidence linking PRT to reduction/prevention of functional decline or improved QOL. AQS=1/9
Poor quality review. Physical activity, Physical tests walking, heart 10 studies reported significant increase in endurance exercise, foundation measures of overall physical activity. Sex and ethnic differences not AQS=2/9 motivational interventions. physical fitness. reported. Small sample sizes makes conclusions difficult to draw.
Progressive resistance training, aerobic training, dynamic exercise, tai chi, high velocity training e.g. concentric training performed at high speed.
Physical activity.
Health category and setting Interventions
Number of studies (subjects) and age
Author
Appendix 6: Reviews of exercise and physical activity interventions.