Physical activity and cognitive function among older adults in China:A systematic review

Background: Physical activity(PA) has been shown to benefit cognitive function in older adults. However, the cognitive benefits of exercising for older Chinese adults have not been systematically documented. This study was to conduct a systematic review on evidence that PA is beneficial for cognitive functioning in older Chinese adults.Methods: Major databases, including Pub Med, EMBASE, Cochrane Library, Wan Fang, CNKI, and VIP, were searched for studies published in English or Chinese between January 2000 and December 2015. Randomized and non-randomized controlled trials(RCTs and non-RCTs), cohort,case-control and cross-sectional studies that evaluated PA and cognitive function among older Chinese adults were included in this review.Results: Of 53 studies included and reviewed, 33 were observational(22 cross-sectional, 7 case-control, and 4 cohort) and 20 were experimental(15 RCTs, 5 non-RCTs). Observational studies showed an association of reduced risk of cognitive-related diseases(i.e., mild cognitive impairment, Alzheimer's disease, and dementia) through PA, whereas experimental studies reported exercise-induced improvement in multiple domains of cognitive function(i.e., global cognitive function, memory, executive function, attention, language, and processing recourse).Conclusion: This systematic review provides initial evidence that PA may benefit cognition in older Chinese adults. Further studies of individuals with cognitive impairments and prospective and RCT studies having high scientific rigor are needed to corroborate the findings reported in this review.

Recruitment of older adults into randomized controlled trials:Issues and lessons learned from two community-based exercise interventions in Shanghai

Background: With the increasing need for high-quality exercise interventions in China, relatively little is known about issues and challenges related to recruitment of older Chinese adults into exercise-based disease prevention interventions. This study aims to describe the recruitment process and outcomes of 2 exercise interventions conducted in Shanghai, China.Methods: Recruitment information was ascertained from 2 community-based randomized controlled trials for 2 exercise interventions, the first designed to improve health outcomes for older women with knee osteoarthritis and the second to study changes in cognitive function in adults with mild cognitive impairment. Results were summarized in terms of recruitment sources, number screened, screening-to-enrollment ratios, and costs.Results: Recruitment was primarily achieved through working with local residential divisions(i.e., neighborhood associations and residential committees). Both studies achieved their planned target number of older adults(45 and 46, respectively) within a 1-year time frame, with a screening-to-randomized ratio of 5:1 and demonstrated excellent retention rates(range 87%–93%) at 6 months. The recruitment cost for the 2studies averaged RMB 189(about USD 30) per initial recruit and RMB 738(about USD 119) per participant randomized. Some major issues encountered during the recruitment process included(1) the use of community neighborhoods to support the conduct of the projects,(2) access to participants, and(3) feasibility.Conclusion: Analysis of the 2 randomized controlled trials has provided valuable insights into the recruitment process and identified resources that can help better planning and recruitment for future interventions. Recommendations aimed at increasing the success of future recruitment efforts are provided.