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      Findings of a Pilot Study Investigating the Effects of Mediterranean Diet and Aerobic Exercise on Cognition in Cognitively Healthy Older People Living Independently within Aged-Care Facilities: The Lifestyle Intervention in Independent Living Aged Care (LIILAC) Study

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          ABSTRACT

          Background

          Cognitive decline and Alzheimer disease are more prevalent in our aging population. Modifiable risk factors, such as diet and sedentary lifestyle, have been proposed as key to potentially ameliorating cognitive decline. Both exercise and Mediterranean diet (MedDiet) have been linked to reduced levels of cardiovascular disease and other comorbidities. Higher levels of exercise and MedDiet adherence may prove to be cognitively protective, both individually and synergistically.

          Objectives

          The aim was to investigate the effect of a 6-mo program of MedDiet, exercise, and a combination of both, on cognition, mood, and general health in older persons living independently in aged-care communities.

          Methods

          The Lifestyle Intervention in Independent Living Aged Care (LIILAC) Study (ACTRN12614001133628) involved 102 participants, aged 60–90 y, who were randomly assigned to 1 of 4 intervention groups. Change in overall memory performance was assessed as the primary outcome. Additionally, changes in cognitive task performance, as well as mood, wellness, cardiovascular function, and blood biomarkers, were investigated.

          Results

          While there was no significant change in overall memory performance, there was a significant improvement in spatial working memory performance in the combined exercise and diet group, relative to controls. This combined intervention group also showed an overall improvement in their emotional state, as assessed by the Depression Anxiety Stress Scale, as did the exercise-only group.

          Conclusions

          This research indicates that diet and exercise programs have the potential to improve aspects of cognition and mood in an aging population. However, given the lower than optimal sample size and lack of resources to reinforce the interventions during the trial, further larger randomized controlled trials are required to substantiate whether the introduction of diet and exercise programs into independent-living facilities is a viable method to preserve cognitive health in older people. This trial was registered at www.ANZCTR.org.au ACTRN 12614001133628 (LIILAC Study)

          Abstract

          This pilot study investigated the effect of a six-month lifestyle intervention program of diet, exercise, and a combination of both, on cognition, mood, and general health in older persons living independently. This unique study was conducted in 15 independent living facilities with testing and administration of interventions to 102 participants aged 60–90 within their own living environments.

          Modifiable risk factors, such as diet and sedentary lifestyle, have been proposed as key to potentially ameliorating cognitive decline. Both exercise and Mediterranean diet (MedDiet) have been linked to reduced levels of cardiovascular disease and other comorbidities. Higher levels of exercise and MedDiet adherence may prove to be cognitively protective, both individually and synergistically.

          This research indicated that diet and exercise programs have the potential to improve aspects of cognition and mood in an aging population. This study has informed a larger study, currently underway, investigating effects of MedDiet and walking program on cognitive decline and general health in a similar demographic.

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          Most cited references37

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          Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis

          Physical exercise is seen as a promising intervention to prevent or delay cognitive decline in individuals aged 50 years and older, yet the evidence from reviews is not conclusive.
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            Western diet consumption and cognitive impairment: links to hippocampal dysfunction and obesity.

            Intake of saturated fats and simple carbohydrates, two of the primary components of a modern Western diet, is linked with the development of obesity and Alzheimer's Disease. The present paper summarizes research showing that Western diet intake is associated with cognitive impairment, with a specific emphasis on learning and memory functions that are dependent on the integrity of the hippocampus. The paper then considers evidence that saturated fat and simple carbohydrate intake is correlated with neurobiological changes in the hippocampus that may be related to the ability of these dietary components to impair cognitive function. Finally, a model is described proposing that Western diet consumption contributes to the development of excessive food intake and obesity, in part, by interfering with a type of hippocampal-dependent memory inhibition that is critical in the ability of animals to refrain from responding to environmental cues associated with food, and ultimately from consuming energy intake in excess of that driven solely by caloric need. Copyright © 2011 Elsevier Inc. All rights reserved.
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              Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples.

              The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in two studies using large clinical samples (N = 437 and N = 241). In Study 1, the three scales comprising the DASS were shown to have excellent internal consistency and temporal stability. An exploratory factor analysis (principal components extraction with varimax rotation) yielded a solution that was highly consistent with the factor structure previously found in nonclinical samples. Between-groups comparisons indicated that the DASS distinguished various anxiety and mood disorder groups in the predicted direction. In Study 2, the conceptual and empirical latent structure of the DASS was upheld by findings from confirmatory factor analysis. Correlations between the DASS and other questionnaire and clinical rating measures of anxiety, depression, and negative affect demonstrated the convergent and discriminant validity of the scales. In addition to supporting the psychometric properties of the DASS in clinical anxiety and mood disorders samples, the results are discussed in the context of current conceptualizations of the distinctive and overlapping features of anxiety and depression.
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                Author and article information

                Contributors
                Journal
                Curr Dev Nutr
                Curr Dev Nutr
                cdn
                Current Developments in Nutrition
                Oxford University Press
                2475-2991
                18 April 2020
                May 2020
                18 April 2020
                : 4
                : 5
                : nzaa077
                Affiliations
                [1 ] Centre for Human Psychopharmacology, Swinburne University of Technology , Melbourne, Australia
                [2 ] Institute for Physical Activity and Nutrition, Deakin University , Geelong, Australia
                Author notes
                Address correspondence to RJH (e-mail: rhardman@ 123456swin.edu.au or rjhardman8@ 123456gmail.com )
                Author information
                http://orcid.org/0000-0002-1304-1341
                Article
                nzaa077
                10.1093/cdn/nzaa077
                7228438
                32440639
                3f06c2fe-6a84-40fa-a1c8-339c7dc1640a
                Copyright © The Author(s) on behalf of the American Society for Nutrition 2020.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 October 2019
                : 18 February 2020
                : 10 April 2020
                Page count
                Pages: 10
                Categories
                ORIGINAL RESEARCH
                Nutrition and Cognitive Function
                AcademicSubjects/MED00060

                aging population,impact of diet,elderly,cognition,mediterranean diet,exercise,blood markers

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