Effects of Multi-Component Exercise and Retraining after Detraining on Functional Fitness and Cognitive Function in Elder People with Mild Dementia
- Seung-youn Hong
- Received February 24, 2014 Accepted March 17, 2014
- ABSTRACT
-
- Background
- With rapid growth in the number of older Koreans and prevalence of dementia, exercise has been emphasized as first, second and third prevention of dementia. A few study, however, investigate effects of detraining and retraining in demented elders. Therefore, the purpose of this study was to investigate the effects of 24 week exercise followed by 12 week detraining and retraining on physical and cognitive function in demented seniors.
- Methods
- Thirty-five demented older adults were assigned into exercise and control group. Exercise group performed multi-component exercise, 2 times a week for 24 weeks. After 12 week detraining, subjects were retraining for 12 weeks. Subjects were tested four times on physiological variables, physical function and cognitive function. Ten subjects in exercise group and 6 subjects in control group were remained at final 48 week, and data from them were analyzed.
- Results
- There were no significant effects on physiological variable in both groups. However, 24 week exercise improved upper and lower body strength, flexibility, dynamic mobility and physical function. These effects, however, were significantly decreased in 12 week detraining period and increased again after 12 week retraining. There were significance group differences. Cognitive function was improved after 24 week exercise but decreased in detraining and retraining period and no significant difference between groups was shown.
- Conclusions
- The present study suggests that positive effects after exercise tend to be reduced once one stops exercise, and be improved again after retraining. Therefore, strategies to encourage demented elders to exercise are needed.
Fig. 1.
Time 1, time 2, time 3, and time 4 indicate baseline, after 24 week exercise, after 12 week detraining, and after 12 week retraining respectively.
Fig. 2.
Time 1, time 2, time 3, and time 4 indicate baseline, after 24 week exercise, after 12 week detraining, and after 12 week retraining respectively. Abbreviations: 244 TUG, 244 cm time to up and go test; SPPB, short physical performance battery; EG, exercise group; CG, control group. 244 TUG was significantly decreased from time 1 to time 4, and SPPB was significantly increased from time 1 to time 4. Wilcox signed rank test was used for assessing their statistical differences.
Table 1.
General characteristics of subjectsa
| Variables | Categories | EG (n=10) | CG (n=6) | χ2 or U | Pb |
|---|---|---|---|---|---|
| Gender | Male | 4 (40.0) | 2 (33.3) | 0.071 | 0.608 |
| Female | 6 (60.0) | 4 (66.7) | |||
| Age, y | 77.10±6.56 | 77.87±50.32 | 68.500 | 0.723 | |
| Weight, kg | 58.33±11.52 | 50.79±6.90 | 50.000 | 0.149 | |
| BMI, kg/m2 | 23.53±3.33 | 22.14±2.36 | 42.500 | 0.166 | |
| FFM, kg | 38.76±5.22 | 33.41±6.04 | 12.000 | 0.064 | |
| Fat, % | 32.44±7.43 | 25.23±7.97 | 39.500 | 0.115 |
Table 2.
General characteristics of dropout vs. no dropout
| Variables | Categories | Dropout (n=19) | No Dropout (n=16) | χ2 or U | Pb |
|---|---|---|---|---|---|
| Gender | Male | 6 (42.9) | 8 (38.1) | 0.079 | 0.526 |
| Female | 8 (57.1) | 13 (61.9) | |||
| Age, y | 80.40±6.62 | 77.87±8.96 | 49.00 | 0.160 | |
| Weight, kg | 49.29±12.11 | 55.32±9.97 | 53.00 | 0.165 | |
| BMI, kg/m2 | 20.69±3.67 | 22.72±2.87 | 40.00 | 0.213 | |
| FFM, kg | 33.71±7.34 | 32.80±6.08 | 47.00 | 0.320 | |
| Body fat, % | 26.26±9.28 | 29.56±8.23 | 50.00 | 0.548 | |
| Chair stand | 4.71±3.20 | 7.97±4.60 | 20.50 | 0.021 | |
| Arm curl | 11.83±7.18 | 10.38±7.18 | 88.50 | 0.732 | |
| One leg stand | 1.99±1.72 | 4.81±6.44 | 69.00 | 0.188 | |
| SPPB | 4.50±2.07 | 6.31±2.92 | 24.50 | 0.112 | |
| MMSE-K | 16.80±7.85 | 16.25±5.36 | 26.50 | 0.721 | |
Table 3.
Homogeneity test for functional fitness and cognitive function of subjectsa
| Variables | EG (n=10) | CG (n=6) | U | Pb |
|---|---|---|---|---|
| Chair stand, times/30 sec | 8.20±3.22 | 7.58±5.76 | 45.500 | 0.337 |
| Arm curl, times/30 sec | 10.20±5.88 | 10.69±6.16 | 63.500 | 0.926 |
| Grip strength, kg | 15.72±6.61 | 13.54±7.24 | 47.000 | 0.242 |
| Lower flexibility, cm | –9.0±10.69 | –14.95±9.78 | 32.500 | 0.184 |
| One leg stand, sec | 5.23±5.27 | 3.75±6.58 | 31.500 | 0.034 |
| 244 TUG, sec | 16.59±7.91 | 15.75±7.55 | 41.000 | 0.744 |
| SPPB, score | 7.00±2.26 | 5.18±3.12 | 29.500 | 0.070 |
| MMSE-K | 18.90±5.84 | 12.86±4.22 | 14.500 | 0.045 |
Table 4.
Changes of physiological variables after exercise training, detraining and retraininga
| Variables | Group | Time 1b | Time 2c | Time 3d | Time 4e | χ2 | Post | U or F |
|---|---|---|---|---|---|---|---|---|
| (a) | (b) | (c) | (d) | (P)f | hocg | (P)h | ||
| Weight, kg |
EG (n=10) CG (n=6) |
58.33±11.52 50.79±6.90 |
59.76±10.04 53.14±6.73 |
61.49±9.24 53.40±9.17 |
62.44±9.34 53.17±9.52 |
5.962 (0.113) 8.478 (0.037) |
NA a<b |
18.500 (0.281) |
| BMI, kg/m2 | EG (n=10) | 23.53±3.33 | 24.21±2.76 | 24.70±2.54 | 25.27±2.57 | 5.771 (0.134) | NA | 21.000 (0.463) |
| CG (n=6) | 22.14±2.44 | 23.43±2.31 | 23.75±3.19 | 24.05±4.05 | 7.271 (0.640) | NA | ||
| FFM, kg | EG (n=10) | 38.76±5.22 | 39.63±5.68 | 39.65±5.38 | 39.99±5.82 | 5.250 (0.154) | NA | 11.500 (0.054) |
| CG (n=6) | 33.41±6.04 | 34.09±6.83 | 33.77±6.80 | 33.84±5.28 | 1.174 (0.759) | NA | ||
| Body fat, % |
EG (n=10) CG (n=6) |
25.23±7.97 32.44±7.43 |
27.05±9.10 33.02±7.28 |
23.67±13.45 34.32±6.68 |
24.80±13.81 35.25±5.87 |
0.724 (0.868) 4.067 (0.254) |
NA NA |
24.000 (0.694) |
| BMR, kcal | EG (n=10) | 1,186±159.59 | 1,204±157.79 | 1,218±156.16 | 1,226±164.28 | 6.910 (0.075) | NA | 11.5000 (0.054) |
| CG (n=6) | 1,235±114.85 | 1,228±133.85 | 1,067±498.60 | 1,065±450.28 | 1.000 (0.801) | NA |
Table 5.
Changes of physical and cognitive function after exercise training, detraining and retraininga
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