Cochrane for Clinicians
Aerobic Activity for Cognitive Function
Am Fam Physician. 2009 Apr 1;79(7):562.
Does aerobic physical activity improve cognitive function in older adults?
Physical activity improves cardiovascular fitness in persons older than 55 years. Cognitive speed and auditory and visual attention are increased in healthy older adults who exercise.
There is a measurable decline in cognitive function that begins at 50 years of age. Cardiovascular fitness may improve cerebral blood flow, oxygen extraction, or glucose metabolism, which has been hypothesized to improve cognitive function.
The authors of this review found 11 studies of adults older than 55 years without cognitive impairments. Studies were generally good quality, but there is a risk of bias because blinding was not practical. Participants in the intervention groups engaged in aerobic exercise. Control groups had no program, or had programs limited to strength, balance, or social or mental activities. Aerobic exercise had a significant effect on cognitive speed, visual and auditory speed, and motor function, but had no significant effect on most other cognitive functions. The maximum volume of oxygen utilization improved in the aerobic exercise group by an average of 16 percent compared with that of the control group, which improved by an average of 2 percent.
Although there is an association between improved cardiovascular fitness and improved cognitive function, it is not clear if aerobic exercise causes the improvements or whether other types of physical exercise might result in the same benefit.
Recommended levels of exercise for older adults are substantial. According to the American College of Sports Medicine and American Heart Association, older adults should engage in aerobic physical activity intense enough to noticably increase heart rate and breathing for a minimum of 30 minutes on five days each week.1 Alternatively, they can engage in aerobic activity that causes large increases of heart rate and breathing for a minimum of 20 minutes on three days each week. Also, twice per week, older adults should engage in activities to maintain or increase muscular strength, endurance, and flexibility.1
Author disclosure: Nothing to disclose.
Angevaren M, Aufdemkampe G, Verhaar HJ, Aleman A, Vanhees L. Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev. 2008;2:CD005381.
1. Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1094–1105.
Copyright © 2009 by the American Academy of Family Physicians.
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