Exercise and creative activities can reduce cognitive decline in older adults

Whitty E, Mansour H, Aguirre E, Palomo M, Charlesworth G, Ramjee S, et al. Efficacy of lifestyle and psychosocial interventions in reducing cognitive decline in older people: Systematic review Ageing Research Reviews. 2020 Sep;62(101113).

Review question

•      Do lifestyle changes, social activities and psychological interventions reduce cognitive decline in healthy people over the age of 50 years old and people with cognitive impairment?

Background

•      Dementia is a crippling condition that affects many adults and poses a challenge for caregivers, but evidence shows that it can be prevented or delayed.

•      Non-pharmacological approaches to prevent dementia in the past have only focused on single behaviours and have been unable to provide an overall recommendation on reducing cognitive decline in those at risk of developing dementia.

•      Interventions such as lifestyle changes (including diet, substance use and exercise), social activities and changing psychosocial approaches to life are promising means to reduce cognitive decline in people at risk of dementia due to age or cognitive impairment.

How the review was done

•      A detailed search of five electronic databases was conducted for all years up to and including April 2019. Studies that evaluated psychosocial or lifestyle interventions that reduced cognitive decline were included in this review. The authors included studies with healthy adults over the age of 50 years old and adults of any age who had memory or cognitive impairment.

•      A total of 2,311 studies were identified in the initial database search, and 64 studies were included in the final review.

•      This review was funded by the Economic and Social Research Council and the National Institute for Health Research (NIHR) in the United Kingdom.

What the researchers found

•      Non-pharmacological interventions were divided into four sub-categories: social activities, dietary interventions, aerobic activities and multidomain interventions combining all three components.

•      High-quality evidence demonstrated that the most effective interventions involved increasing participants' physical activity levels twice a week for six months.

•      Studies that evaluated only dietary interventions did not demonstrate improvements in cognition levels.

•      Lower quality evidence found that creative art or storytelling groups once or twice per week; resistance training for 6-12 months and Tai Chi practised regularly at home, improved functioning and memory in people with mild cognitive impairment.

Conclusion

•      In order to improve cognition, memory and executive functions, this review recommends group therapy carried out for at least 4 months, promoting weekly engagement in aerobic or resistance exercise, and creative tasks.

•      Future interventions must encourage participants to continue to increase activity levels beyond facilitated sessions in order to be cost-effective.