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Effekte körperlicher Aktivität und körperlichen Trainings auf den psychischen Status bei älteren Menschen mit und ohne kognitive Schädigung

Effects of physical activity and physical training on the psychological status of older persons with and without cognitive impairment

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Zusammenfassung

Sturzangst und Depressionen im Alter und bei Menschen mit kognitiver Einschränkung führen zu verminderter Lebensqualität. Körperliche Aktivität ist in repräsentativen Quer- und Längsschnittstudien mit einer verbesserten mentalen Gesundheit assoziiert. Dies gilt vor allem für Depressionen. Der Nachweis eines Zusammenhangs hinsichtlich der Sturzangst ist allerdings mangelhaft untersucht. Die vorliegende Übersichtsarbeit fasst den derzeitigen Stand epidemiologischer und randomisierter kontrollierter Studien (RCTs) zusammen und gibt einen Ausblick auf zukünftige Forschungsperspektiven. Die Mehrzahl der Studien belegt eine signifikante Reduktion von Depression und Sturzangst durch körperliches Training bei älteren Menschen, jedoch mit unzureichender Evidenz für kognitiv eingeschränkte Personen. Empfehlungen in Bezug auf Intensität, Dauer und Umfang des Trainings können aufgrund der geringen Anzahl an qualitativ hochwertigen vergleichenden RCTs nur eingeschränkt gegeben werden. Zur Reduktion von Depressionen wirkt ein intensives Kraft- oder Ausdauertraining, zur Verringerung der Sturzangst eine Teilnahme an Tai-Chi oder in multifaktoriellen Trainingsprogrammen am effektivsten.

Abstract

Fear of falling and depression in the elderly and among cognitively impaired people lead to restrictions in quality of life. Being more active is associated with improved mental health as documented in cross-sectional and longitudinal studies. This is especially true for depression. Such epidemiologic evidence is lacking in fear of falling. This review summarizes current evidence from epidemiological and randomized controlled trials (RCTs) and gives an outlook for future research perspectives. The majority of studies included in this review document a significant reduction of depression and fear of falling in older persons by physical training with less evidence in persons with cognitive impairment. With respect to intensity, duration, and amount of exercise, evidence-based recommendations were limited by the small number of high-quality comparative RCTs. High-intensity strength or endurance training was the most effective for reducing depression, while participation in Tai-Chi or multifactorial training programs was most effective to reduce fear of falling.

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Danksagung

Die Studie wurde unterstützt von der Dietmar Hopp Stiftung und durch ein Stipendium des Graduiertenkollegs Demenz der Robert Bosch Stiftung und des Netzwerks Alternsforschung der Universität Heidelberg (NAR)

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  1. AGAPLESION Bethanien Krankenhaus, Geriatrisches Zentrum an der Universität Heidelberg, Rohrbacher Str. 149, 69126, Heidelberg, Deutschland

    S. Gogulla, N. Lemke & K. Hauer

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Gogulla, S., Lemke, N. & Hauer, K. Effekte körperlicher Aktivität und körperlichen Trainings auf den psychischen Status bei älteren Menschen mit und ohne kognitive Schädigung. Z Gerontol Geriat 45, 279–289 (2012). https://doi.org/10.1007/s00391-012-0347-x

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