Bewegung und körperliches Training als Interventionen in der Gerontopsychiatrie

Exercise and physical training as interventions in gerontopsychiatry

Zusammenfassung

Die Behandlung von psychischen Krankheitsbildern älterer Menschen ist oftmals durch Limitationen in der Wirksamkeit und Verträglichkeit der pharmakologisch dominierten Standardtherapie geprägt. Wirksame Alternativen und Ergänzungen durch nichtpharmakologische Therapieverfahren spielen daher bei diesen Patienten eine besonders eminente Rolle. Bewegung und körperliches Training sind Interventionen, für deren Effektivität eine hohe Evidenz in der Prophylaxe und Therapie von psychischen und kognitiven Störungen besteht. Dieser Beitrag basiert auf einer selektiven Literatursuche und gibt einen Überblick über den aktuellen Wissensstand in Bezug auf die Wirkmechanismen, die Effekte auf häufig auftretende Störungsbilder und die Modalitäten der Interventionen.

Abstract

The treatment of mental disorders in older adults is often restricted by limitations in efficacy and tolerability of pharmacologically dominated standard therapeutic strategies. Therefore, nonpharmacological therapeutic alternatives and supplements play a crucial role in these patients. Structured exercise and training are interventions that are associated with a high level of evidence in prevention and treatment of mental and cognitive disorders. This article is based on a selective search of the literature and provides an overview of the current scientific evidence with respect to the mechanisms of action, the effects on frequently occurring clinical disorders and modalities of the exercise interventions.

This is a preview of subscription content, access via your institution.

Literatur

  1. 1.

    Alamo C, López-Muñoz F, García-García P et al (2014) Risk-benefit analysis of antidepressant drug treatment in the elderly. Psychogeriatrics 14:261–268

    PubMed  Google Scholar 

  2. 2.

    Anderson-Hanley C, Barcelos NM, Zimmerman EA et al (2018) The aerobic and cognitive exercise study (ACES) for community-dwelling older adults with or at-risk for mild cognitive impairment (MCI): neuropsychological, neurobiological and neuroimaging outcomes of a randomized clinical trial. Front Aging Neurosci 10:76

    PubMed  PubMed Central  Google Scholar 

  3. 3.

    Apóstolo J, Dixe MDA, Bobrowicz-Campos E et al (2019) Effectiveness of a combined intervention on psychological and physical capacities of frail older adults: a cluster randomized controlled trial. Int J Environ Res Public Health 16:3125

    PubMed Central  Google Scholar 

  4. 4.

    Ashdown-Franks G, Koyanagi A, Vancampfort D (2018) Sedentary behavior and perceived stress among adults aged ≥50 years in six low- and middle-income countries. Maturitas 116:100–107

    PubMed  Google Scholar 

  5. 5.

    Barha CK, Davis JC, Falck RS et al (2017) Sex differences in exercise efficacy to improve cognition: a systematic review and meta-analysis of randomized controlled trials in older humans. Front Neuroendocrinol 46:71–85

    PubMed  Google Scholar 

  6. 6.

    Barreto Pde S, Demougeot L, Pillard F et al (2015) Exercise training for managing behavioral and psychological symptoms in people with dementia: a systematic review and meta-analysis. Ageing Res Rev 24(Pt B):274–285

    PubMed  Google Scholar 

  7. 7.

    Bartholomew JB, Morrison D, Ciccolo JT (2005) Effects of acute exercise on mood and well-being in patients with major depressive disorder. Med Sci Sports Exerc 37:2032–2037

    PubMed  Google Scholar 

  8. 8.

    Belvederi Murri M, Amore M, Menchetti M et al (2015) Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group. Physical exercise for late-life major depression. Br J Psychiatry 207:235–242

    CAS  PubMed  Google Scholar 

  9. 9.

    Bernard P, Ninot G, Bernard PL et al (2015) Effects of a six-month walking intervention on depression in inactive post-menopausal women: a randomized controlled trial. Aging Ment Health 19:485–492

    CAS  PubMed  Google Scholar 

  10. 10.

    Brehm K, Dallmann P, Freyer T et al (2020) Angebot und Inanspruchnahme von Sporttherapie in psychiatrischen Kliniken in Deutschland. Nervenarzt 91:642–650

    PubMed  Google Scholar 

  11. 11.

    Burton E, Cavalheri V, Adams R et al (2015) Effectiveness of exercise programs to reduce falls in older people with dementia living in the community: a systematic review and meta-analysis. Clin Interv Aging 10:421–434

    PubMed  PubMed Central  Google Scholar 

  12. 12.

    Cooney GM, Dwan K, Greig C et al (2013) Exercise for depression. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD004366.pub6

    Article  PubMed  Google Scholar 

  13. 13.

    de Oliveira LDSSCB, Souza EC, Rodrigues RAS, Fett CA et al (2019) The effects of physical activity on anxiety, depression, and quality of life in elderly people living in the community. Trends Psychiatry Psychother 41:36–42

    PubMed  Google Scholar 

  14. 14.

    DeBoer LB, Powers MB, Utschig AC et al (2012) Exploring exercise as an avenue for the treatment of anxiety disorders. Expert Rev Neurother 12:1011–1022

    CAS  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Denkinger M, Nikolaus T, Denkinger C et al (2012) Physical activity for the prevention of cognitive decline. Z Gerontol Geriat 45:11–16

    CAS  Google Scholar 

  16. 16.

    DGPPN, BÄK, KBV, AWMF (Hrsg) (2015) S3-Leitlinie/Nationale VersorgungsLeitlinie Unipolare Depression – Langfassung, 2. Auflage. Version 5. www.depression.versorgungsleitlinien.de.. Zugegriffen: 2020-08-20. https://doi.org/10.6101/AZQ/000364 (für die Leitliniengruppe Unipolare Depression)

  17. 17.

    Dimidjian S, Barrera M Jr, Martell C et al (2011) The origins and current status of behavioral activation treatments for depression. Annu Rev Clin Psychol 7:1–38

    PubMed  Google Scholar 

  18. 18.

    Ferreira RM, Alves WMGDC, de Lima TA et al (2018) The effect of resistance training on the anxiety symptoms and quality of life in elderly people with Parkinson’s disease: a randomized controlled trial [published correction in Arq Neuropsiquiatr 2018;76:1. Arq Neuropsiquiatr 76:499–506

    PubMed  Google Scholar 

  19. 19.

    Fleiner T, Dauth H, Gersie M et al (2017) Structured physical exercise improves neuropsychiatric symptoms in acute dementia care: a hospital-based RCT. Alzheimers Res Ther 9:68

    PubMed  PubMed Central  Google Scholar 

  20. 20.

    Fleiner T, Dauth H, Zijlstra W et al (2020) A structured physical exercise program reduces professional Caregiver’s burden caused by neuropsychiatric symptoms in acute dementia care: randomized controlled trial results. J Alzheimers Dis 74:429–433

    PubMed  Google Scholar 

  21. 21.

    Foley DJ, Monjan AA, Brown SL et al (1995) Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 18:425–432

    CAS  PubMed  Google Scholar 

  22. 22.

    Forbes D, Forbes SC, Blake CM et al (2015) Exercise programs for people with dementia. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD006489.pub3

    Article  PubMed  Google Scholar 

  23. 23.

    Galloza J, Castillo B, Micheo W (2017) Benefits of exercise in the older population. Phys Med Rehabil Clin N Am 28:659–669

    PubMed  Google Scholar 

  24. 24.

    Gual N, García-Salmones M, Brítez L et al (2020) The role of physical exercise and rehabilitation in delirium. Eur Geriatr Med 11:83–93

    CAS  PubMed  PubMed Central  Google Scholar 

  25. 25.

    Hampel H, O’Bryant SE, Molinuevo JL et al (2018) Blood-based biomarkers for Alzheimer disease: mapping the road to the clinic. Nat Rev Neurol 14:639–652

    PubMed  PubMed Central  Google Scholar 

  26. 26.

    Herbolsheimer F, Riepe MW, Peter R (2018) Cognitive function and the agreement between self-reported and accelerometer-accessed physical activity. BMC Geriatr 18:56

    PubMed  PubMed Central  Google Scholar 

  27. 27.

    Hersi M, Irvine B, Gupta P et al (2017) Risk factors associated with the onset and progression of Alzheimer’s disease: a systematic review of the evidence. Neurotoxicology 61:143–187

    PubMed  Google Scholar 

  28. 28.

    Kendrick D, Kumar A, Carpenter H et al (2014) Exercise for reducing fear of falling in older people living in the community. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD009848.pub2

    Article  PubMed  PubMed Central  Google Scholar 

  29. 29.

    Kurdi FN, Rc F (2019) Physical exercise increased brain-derived neurotrophic factor in elderly population with depression. Open Access Maced J Med Sci 7:2057–2061

    PubMed  PubMed Central  Google Scholar 

  30. 30.

    Lamb SE, Sheehan B, Atherton N et al (2018) Dementia And Physical Activity (DAPA) trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial. BMJ 361:k1675

    PubMed  PubMed Central  Google Scholar 

  31. 31.

    Lamotte G, Shah RC, Lazarov O et al (2017) Exercise training for persons with alzheimer’s disease and Caregivers: a review of dyadic exercise interventions. J Mot Behav 49:365–377

    PubMed  Google Scholar 

  32. 32.

    Lee PG, Jackson EA, Richardson CR (2017) Exercise prescriptions in older adults. Am Fam Physician 95:425–432

    PubMed  Google Scholar 

  33. 33.

    Livingston G, Huntley J, Sommerlad A et al (2020) Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 396:413–446

    PubMed  PubMed Central  Google Scholar 

  34. 34.

    Livingston G, Sommerlad A, Orgeta V (2017) Dementia prevention, intervention, and care. Lancet 390:2673–2734

    PubMed  Google Scholar 

  35. 35.

    Marinus N, Hansen D, Feys P et al (2019) The impact of different types of exercise training on peripheral blood brain-derived neurotrophic factor concentrations in older adults: a meta-analysis. Sports Med 49:1529–1546

    PubMed  Google Scholar 

  36. 36.

    Matta Mello Portugal E, Cevada T, Sobral Monteiro-Junior R et al (2013) Neuroscience of exercise: from neurobiology mechanisms to mental health. Neuropsychobiology 68:1–14

    PubMed  Google Scholar 

  37. 37.

    Mendonca GV, Pezarat-Correia P, Vaz JR et al (2016) Impact of exercise training on physiological measures of physical fitness in the elderly. Curr Aging Sci 9:240–259

    PubMed  Google Scholar 

  38. 38.

    Micheli L, Ceccarelli M, D’Andrea G, Tirone F (2018) Depression and adult neurogenesis: positive effects of the antidepressant fluoxetine and of physical exercise. Brain Res Bull 143:181–193

    CAS  PubMed  PubMed Central  Google Scholar 

  39. 39.

    Morris JK, Vidoni ED, Johnson DK et al (2017) Aerobic exercise for Alzheimer’s disease: a randomized controlled pilot trial. PLoS ONE 12:e170547

    PubMed  PubMed Central  Google Scholar 

  40. 40.

    Neikrug AB, Ancoli-Israel S (2010) Sleep disorders in the older adult—a mini-review. Gerontology 56:181–189

    PubMed  Google Scholar 

  41. 41.

    Nigdelis MP, Martínez-Domínguez SJ, Goulis DG (2018) Effect of programmed exercise on perceived stress in middle-aged and old women: a meta-analysis of randomized trials. Maturitas 114:1–8

    PubMed  Google Scholar 

  42. 42.

    Northey JM, Cherbuin N, Pumpa KL et al (2018) Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. Br J Sports Med 52:154–160

    PubMed  Google Scholar 

  43. 43.

    Nyboe L, Lund H (2013) Low levels of physical activity in patients with severe mental illness. Nord J Psychiatry 67:43–46

    PubMed  Google Scholar 

  44. 44.

    Pérez-López FR, Martínez-Domínguez SJ, Lajusticia H et al (2017) Health outcomes systematic analyses project. Effects of programmed exercise on depressive symptoms in midlife and older women: a meta-analysis of randomized controlled trials. Maturitas 106:38–47

    PubMed  Google Scholar 

  45. 45.

    Phillips C (2017) Brain-derived neurotrophic factor, depression, and physical activity: making the neuroplastic connection. Neural Plast 2017:7260130

    PubMed  PubMed Central  Google Scholar 

  46. 46.

    Puterman E, Weiss J, Lin J et al (2018) Aerobic exercise lengthens telomeres and reduces stress in family caregivers: a randomized controlled trial—Curt Richter award paper 2018. Psychoneuroendocrinology 98:245–252

    CAS  PubMed  Google Scholar 

  47. 47.

    Rashid MH, Zahid MF, Zain S, Kabir A, Hassan SU (2020) The neuroprotective effects of exercise on cognitive decline: a preventive approach to alzheimer disease. Cureus 12:e6958

    PubMed  PubMed Central  Google Scholar 

  48. 48.

    Schuch FB, Vancampfort D, Rosenbaum S et al (2016) Exercise for depression in older adults: a meta-analysis of randomized controlled trials adjusting for publication bias. Braz J Psychiatry 38:247–254

    PubMed  PubMed Central  Google Scholar 

  49. 49.

    Schwenk M, Zieschang T, Englert S et al (2014) Improvements in gait characteristics after intensive resistance and functional training in people with dementia: a randomised controlled trial. BMC Geriatr 14:73

    PubMed  PubMed Central  Google Scholar 

  50. 50.

    Song D, Yu DSF, Li PWC et al (2018) The effectiveness of physical exercise on cognitive and psychological outcomes in individuals with mild cognitive impairment: a systematic review and meta-analysis. Int J Nurs Stud 79:155–164

    PubMed  Google Scholar 

  51. 51.

    Ströhle A (2019) Sports psychiatry: mental health and mental disorders in athletes and exercise treatment of mental disorders. Eur Arch Psychiatry Clin Neurosci 269:485–498

    PubMed  Google Scholar 

  52. 52.

    Toots A, Littbrand H, Lindelöf N et al (2016) Effects of a high-intensity functional exercise program on dependence in activities of daily living and balance in older adults with dementia. J Am Geriatr Soc 64:55–64

    PubMed  PubMed Central  Google Scholar 

  53. 53.

    Vanderlinden J, Boen F, van Uffelen JGZ (2020) Effects of physical activity programs on sleep outcomes in older adults: a systematic review. Int J Behav Nutr Phys Act 17:11

    CAS  PubMed  PubMed Central  Google Scholar 

  54. 54.

    Venturelli M, Sollima A, Cè E et al (2016) Effectiveness of exercise- and cognitive-based treatments on salivary Cortisol levels and sundowning syndrome symptoms in patients with alzheimer’s disease. J Alzheimers Dis 53:1631–1640

    CAS  PubMed  Google Scholar 

  55. 55.

    Wetherell JL, Bower ES, Johnson K et al (2018) Integrated exposure therapy and exercise reduces fear of falling and avoidance in older adults: a randomized pilot study. Am J Geriatr Psychiatry 26:849–859

    PubMed  PubMed Central  Google Scholar 

  56. 56.

    World Health Organization (2010) Global recommendations on physical activity for health: age group 65 years and above. WHO press, Geneva. ISBN 978-92-4-159997‑9

    Google Scholar 

  57. 57.

    World Health Organization (2019) Risk reduction of cognitive decline and dementia: WHO guidelines. WHO, Geneva. ISBN 978-92-4-155054‑3

    Google Scholar 

  58. 58.

    Zhou XL, Wang LN, Wang J et al (2018) Effects of exercise interventions for specific cognitive domains in old adults with mild cognitive impairment: a protocol of subgroup meta-analysis of randomized controlled trials. Medicine 97:e13244

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Dr. Karsten Henkel.

Ethics declarations

Interessenkonflikt

K. Henkel gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden vom Autor keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Henkel, K. Bewegung und körperliches Training als Interventionen in der Gerontopsychiatrie. Z Gerontol Geriat 53, 728–734 (2020). https://doi.org/10.1007/s00391-020-01810-6

Download citation

Schlüsselwörter

  • Demenz
  • Depression
  • Kognition
  • „Brain-derived neurotrophic factor“
  • Ältere

Keywords

  • Dementia
  • Depression
  • Cognition
  • Brain-derived neurotrophic factor
  • Aged