Tuesday, January 26, 2010

Resistance training improves mental function in the elderly

In this entry I'll present material from a recently-published study1 that offers compelling evidence that resistance training can improve mental function as we age. I'd be a bit young to qualify for a study like this--plus I'm the wrong gender (it was an all-woman test group)--but the results are nonetheless heartening to those of us drawing closer to the ages of the participants (65-75).

Here are some salient--though somewhat technical--excerpts:
Resistance Training and Executive Functions A 12-Month Randomized Controlled Trial
Teresa Liu-Ambrose, PhD, PT; Lindsay S. Nagamatsu, MA; Peter Graf, PhD;
B. Lynn Beattie, MD; Maureen C. Ashe, PhD, PT; Todd C. Handy, PhD


Background: Cognitive decline among seniors is a pressing health care issue. Specific exercise training may combat cognitive decline. We compared the effect of once-weekly and twice-weekly resistance training with that of twice-weekly balance and tone exercise training on the performance of executive cognitive functions in senior women.

Methods: In this single-blinded randomized trial, 155 community-dwelling women aged 65 to 75 years living in Vancouver were randomly allocated to once-weekly (n = 54) or twice-weekly (n = 52) resistance training or twice-weekly balance and tone training (control group) (n = 49). The primary outcome measure was performance on the Stroop test, an executive cognitive test of selective attention and conflict resolution. Secondary outcomes of executive cognitive functions included set shifting as measured by the Trail Making Tests (parts A and B) and working memory as assessed by verbal digit span forward and backward tests. Gait speed, muscular function, and whole-brain volume were also secondary outcome measures.

Results: Both resistance training groups significantly improved their performance on the Stroop test compared with those in the balance and tone group (P .03). Task performance improved by 12.6% and 10.9% in the once-weekly and twice-weekly resistance training groups, respectively; it deteriorated by 0.5% in the balance and tone group. Enhanced selective attention and conflict resolution was significantly associated with increased gait speed. Both resistance training groups demonstrated reductions in whole-brain volume compared with the balance and tone group at the end of the study (P .03).

Conclusion: Twelve months of once-weekly or twice-weekly resistance training benefited the executive cognitive function of selective attention and conflict resolution among senior women.
Ok, so they divided this group of ladies into two sub-groups and had each perform a type of exercises. One type of exercise was resistance training--what I would call strength training--while the other group did balance and toning exercises. What, exactly, were the exercises they were doing? Further on, the article indicates the following:
Resistance Training
The resistance training program used a progressive, high-intensity protocol. The air-pressured digital resistance leg press machine and free weights were used to provide the training stimulus. The leg press machine­ based exercises consisted of biceps curls, triceps extension, seated rowing, latissimus dorsi pull-down exercises, leg presses, hamstring curls, and calf raises. The intensity of the training stimulus was at a work range of 6 to 8 repetitions (2 sets). The training stimulus was subsequently increased using the 7-RM method, when 2 sets of 6 to 8 repetitions were completed with proper form and without discomfort. Other key strength exercises included minisquats, mini-lunges, and lunge walks. The number of sets completed and the load lifted for each exercise were recorded for each participant at every class.

Balance and Tone
The balance and tone program consisted of stretching exercises, range-of-motion exercises, basic core-strength exercises including kegels (ie, exercises to strengthen the pelvic floor muscles), balance exercises, and relaxation techniques. Key balance exercises included tai chi­based forms (ie, the crane and the tree pose), tandem stand, tandem walking, and single leg stance (eyes opened and closed). Other than body weight, no additional loading (eg, hand weights or resistance bands) was applied to any of the exercises. There is no evidence that these exercises improve cognitive function. This group served to control for confounding variables such as physical training received by traveling to the training centers, social interaction, and changes in lifestyle secondary to study participation.
Glad they didn't mention tandem riding under the Balance and Tone category . . .

Actually, on that note, the authors mention the following: "intervention studies have shown that aerobic exercise training enhances brain and cognitive function." So it seems it's already been established that aerobic exercise enhances brain function in older subjects: this study's aim, on the other hand, was to see whether the same or similar benefits would come from resistance training.

So the ladies doing the resistance training made notable improvements in one area of mental function--what the authors call "enhanced selective attention and conflict resolution"--though not in other areas. Interestingly, the authors mention a similar study done with male participants that showed improvements in other areas of brain function:
Cassilhas et al demonstrated that 6 months of thrice-weekly moderate- or high-intensity resistance training improved cognitive performance of memory and verbal concept formation among senior men. Our findings extend these results in several critical ways. Most notably, our results suggest that the effects of resistance training on executive cognitive functions appear to be selective; that is, resistance training enhanced selective attention and conflict resolution in older women, but cognitive abilities associated with manipulating verbal information in working memory and shifting between task sets or instructions were not improved.
Still, the net result of the study seems to be that, as we age, brain and cognitive function can be enhanced by exercise--whether of the strength- or resistance-training, or of the aerobic sort--or both.
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1 Arch Intern Med. 2010;170(2):170-178

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