Does Strength-Promoting Exercise Confer Unique Health Benefits? A Pooled Analysis of Data on 11 Population Cohorts With All-Cause, Cancer, and Cardiovascular Mortality Endpoints

Public health guidance includes strength-promoting exercise (SPE) but there is little evidence on its links with mortality. Using data from 11 cohorts we examined the associations between SPE (gym-based and own bodyweight strength activities) and all-cause, cancer, and cardiovascular disease (CVD) mortality. Multivariable-adjusted Cox regression examine the associations between SPE (any, low/high volume, adherence to SPE guideline) and mortality. The core sample comprised 80,306 adults aged ≥30 years corresponding to 5,763 any cause deaths (681,790 person years). Following exclusions for prevalent disease/events in the first 24 months, participation in any SPE was favorably associated with all cause (0.77, 95% confidence interval: 0.69 to 0.87) and cancer mortality (0.69, 0.56 to 0.86). Adhering only to the SPE guideline of (≥2 sessions/week) was associated with cancer (0.66, 0.48 to 0.92) and all-cause (0.79, 0.66 to 0.94) mortality; adhering only to the aerobic guideline (150 minutes/week of moderate or 75 minutes/week of vigorous intensity or equivalent combinations) was associated with all-cause (0.84, 0.78 to 0.90) and CVD (0.78, 0.68 to 0.90) mortality. Adherence to both guidelines was associated with all-cause (0.71, 0.57 to 0.87), and cancer (0.70, 0.50 to 0.98) mortality. Our results support promoting adherence to the strength exercise guidelines over and above the generic physical activity targets

Exercise for Individuals with Lewy Body Dementia: A Systematic Review

<div><p>Background</p><p>Individuals with Lewy body Dementia (LBD), which encompasses both Parkinson disease dementia (PDD) and Dementia with Lewy Bodies (DLB) experience functional decline through Parkinsonism and sedentariness exacerbated by motor, psychiatric and cognitive symptoms. Exercise may improve functional outcomes in Parkinson’s disease (PD), and Alzheimer’s disease (AD). However, the multi-domain nature of the LBD cluster of symptoms (physical, cognitive, psychiatric, autonomic) results in vulnerable individuals often being excluded from exercise studies evaluating physical function in PD or cognitive function in dementia to avoid confounding results. This review evaluated existing literature reporting the effects of exercise interventions or physical activity (PA) exposure on cluster symptoms in LBD.</p><p>Methods</p><p>A high-sensitivity search was executed across 19 databases. Full-length articles of any language and quality, published or unpublished, that analysed effects of isolated exercise/physical activity on indicative Dementia with Lewy Bodies or PD-dementia cohorts were evaluated for outcomes inclusive of physical, cognitive, psychiatric, physiological and quality of life measures. The protocol for this review (Reg. #: CRD42015019002) is accessible at <a href="http://www.crd.york.ac.uk/PROSPERO/" target="_blank">http://www.crd.york.ac.uk/PROSPERO/</a>.</p><p>Results</p><p>111,485 articles were initially retrieved; 288 full articles were reviewed and 89.6% subsequently deemed ineligible due to exclusion of participants with co-existence of dementia and Parkinsonism. Five studies (1 uncontrolled trial, 1 randomized controlled trial and 3 case reports) evaluating 16 participants were included. Interventions were diverse and outcome homogeneity was low. Habitual gait speed outcomes were measured in 13 participants and increased (0.18m/s, 95% CI -0.02, 0.38m/s), exceeding moderate important change (0.14m/s) for PD cohorts. Other outcomes appeared to improve modestly in most participants.</p><p>Discussion</p><p>Scarce research investigating exercise in LBD exists. This review confirms exercise studies in PD and dementia consistently exclude LBD participants. Results in this cohort must be treated with caution until robustly designed, larger studies are commissioned to explore exercise efficacy, feasibility and clinical relevance.</p></div

Cohort Characteristics.

<p>Data reported in brackets as mean standard deviation (SD) or as individual values where appropriate. NR—Not reported, PDD—Parkinson’s disease dementia, DLB—dementia with Lewy bodies, MMSE—Mini-mental State Exam score; ranges from 0—30 with higher scores indicative of better cognitive function, UPDRS—unified Parkinson’s disease rating scale (part I—mentation, II—Activities of daily living, III—motor).</p

Performance based tests of function.

<p>N/A = not applicable, NR = not reported.</p

CARE Criteria: Case report studies.

<p>CARE Criteria: Case report studies.</p

sj-docx-2-ggm-10.1177_23337214231203472 – Supplemental material for Caring for Informal Dementia Caregivers and Their Loved Ones Via the HOMeCARE Exercise and Mindfulness for Health Program (HOMeCARE): A Randomized, Single-Blind, Controlled Trial

Supplemental material, sj-docx-2-ggm-10.1177_23337214231203472 for Caring for Informal Dementia Caregivers and Their Loved Ones Via the HOMeCARE Exercise and Mindfulness for Health Program (HOMeCARE): A Randomized, Single-Blind, Controlled Trial by Tommy Lang, Kenneth Daniel, Michael Inskip, Yorgi Mavros and Maria A. Fiatarone Singh, AM in Gerontology and Geriatric Medicine</p

Intervention Characteristics. NR—Not reported.

<p>Intervention Characteristics. NR—Not reported.</p

PRISMA flow chart of search.

<p>PRISMA flow chart of search.</p

sj-docx-7-ggm-10.1177_23337214231203472 – Supplemental material for Caring for Informal Dementia Caregivers and Their Loved Ones Via the HOMeCARE Exercise and Mindfulness for Health Program (HOMeCARE): A Randomized, Single-Blind, Controlled Trial

Supplemental material, sj-docx-7-ggm-10.1177_23337214231203472 for Caring for Informal Dementia Caregivers and Their Loved Ones Via the HOMeCARE Exercise and Mindfulness for Health Program (HOMeCARE): A Randomized, Single-Blind, Controlled Trial by Tommy Lang, Kenneth Daniel, Michael Inskip, Yorgi Mavros and Maria A. Fiatarone Singh, AM in Gerontology and Geriatric Medicine</p

sj-docx-10-ggm-10.1177_23337214231203472 – Supplemental material for Caring for Informal Dementia Caregivers and Their Loved Ones Via the HOMeCARE Exercise and Mindfulness for Health Program (HOMeCARE): A Randomized, Single-Blind, Controlled Trial

Supplemental material, sj-docx-10-ggm-10.1177_23337214231203472 for Caring for Informal Dementia Caregivers and Their Loved Ones Via the HOMeCARE Exercise and Mindfulness for Health Program (HOMeCARE): A Randomized, Single-Blind, Controlled Trial by Tommy Lang, Kenneth Daniel, Michael Inskip, Yorgi Mavros and Maria A. Fiatarone Singh, AM in Gerontology and Geriatric Medicine</p