Effects of physical exercise intervention on functional and cognitive decline in geriatric hospitalized patients

Resumen

The current Ph.D. dissertation revolves around the effects of a physical exercise intervention on functional capacity and cognitive function in acutely hospitalized older adults. It has been suggested that acute medical illnesses and subsequent hospitalization are major events leading to disability in older people. A physical exercise intervention can be an effective therapy to reverse the functional and cognitive decline associated with acute hospitalization in very old patients. This thesis doctoral is based on 6 scientific studies that have been published or submitted for publication in scientific international journals. The first study (Chapter 1), we aimed to examine the role of different physical exercise programs (aerobic, resistance, and multicomponent training) on cognitive function in healthy older adults. The data presented in the following studies were collected in the same research project (ClinicalTrials.gov NCT02300896 registered on November 19, 2014). In the second study (Chapter 2), the main purpose was to assess the effects of a multicomponent exercise intervention on functional, cognitive function, and well-being status in very old patients admitted to the ACE unit. The third study (Chapter 3) to analyze the effects of physical exercise on functional capacity, maximal muscle strength and muscle power output during hospital stay in older adults. The fourth study (Chapter 4), we aimed to compare differences on gait characteristics and muscle performance endpoints (i.e., muscle strength and muscle power output) of older medical patients admitted to the ACE unit based on the functional status presented at admission, and to determine the mechanisms underlying the gait impairment. In the fifth study (Chapter 5), we investigated the inter-individual variability in the response to physical exercise and usual care (as indicated by functional, muscle strength and cognitive endpoints) of older adults, and the relationship between the response to the intervention with mortality at one-year post-discharge. In the last study (Chapter 6), the main purpose was to assess the effects of the multicomponent exercise training program on specific cognitive domains including executive function and verbal fluency in acutely hospitalized old patients.