Impact of Exercise Interventions on Sustained Brain Health Outcomes in Frail Older Individuals: A Comprehensive Review of Systematic Reviews

Healthcare (Basel). 2023 Dec 13;11(24):3160. doi: 10.3390/healthcare11243160.

Abstract

Several systematic review studies highlight exercise's positive impact on brain health outcomes for frail individuals. This study adopts a Comprehensive Review of reviews (CRs) approach to amalgamate data from existing reviews, focusing on exercise's influence on brain health outcomes in older frail and pre-frail adults. The methodology involves a thorough search of Portuguese, Spanish, and English-indexed databases (i.e., Ebsco Health, Scielo, ERIC, LILACS, Medline, Web of Science, SportDiscus) from 1990 to 2022, with the AMSTAR-2 tool assessing evidence robustness. The search terms "physical exercise", "elderly frail", and "systematic review" were employed. Results: Out of 12 systematically reviewed studies, four presented high-quality (with metanalyses), while eight exhibit critically low quality. Positive trends emerge in specific cognitive and neuromotor aspects, yet challenges persist in psychosocial domains, complex cognitive tasks, and ADL outcomes. This study yields reasonable and promising evidence regarding exercise's influence on quality of life and depression in frail older individuals. However, the impact on biochemical markers remains inconclusive, emphasizing the need for standardized methodologies. Conclusions: The findings highlight the importance of acknowledging methodological nuances for clinicians and policymakers when translating these results into impactful interventions for aging populations. This emphasizes the necessity for a comprehensive and customized approach to exercise interventions aimed at fostering the sustainability of overall well-being in older individuals, aligning with United Nations Sustainable Development Goal 3.

Keywords: dementia; emotional well-being; multicomponent exercise; muscle strength; pre-frail; quality of evidence; sustainability development goals.

Publication types

  • Review

Grants and funding

G.E.F. thanks the National funding by FCT—Foundation for Science and Technology, P.T., through the institutional scientific employment program-contract (CEECINST/00077/2021). A.L.L.B. was supported by São Paulo Research Foundation (FAPESP, grants nº10/50025-1, 2016/04845-3, and 2019/14115-0), and National Council of Scientific and Technology Development (CNPq, grant nº 307674/2017-7).