For mild cognitive impairment, moderate exercise doses gave the most reliable executive-function gains

The edition in brief

A Bayesian dose-response network meta-analysis of 38 randomised trials in adults aged 60 or over with mild cognitive impairment found non-linear effects of exercise on executive function: moderate doses of about 300 to 1,000 MET-minutes a week gave the most reliable gains in working memory, flexibility and inhibitory control, with plateaus or slight declines above that. Exercise combined with cognitive training helped working memory most; combined physical training and walking helped flexibility and inhibition. Certainty was low to moderate. A Medicare-linked US study of 4,527 discharges home after short nursing-home rehabilitation found 15.8% readmitted within 30 days; a dementia diagnosis was not associated with readmission, whereas prior hospital or emergency use and comorbidity burden were, and being married was protective. In 9,971 older Australians from the STAREE trial baseline, prescribed opioid use was associated with lower quality of life after adjustment (β −7.6 on SF-36), with physical functioning 20 to 25 points lower. A cluster-randomised trial of nurse-led exercise in 56 haemodialysis patients with sarcopenia found it safe, with favourable but non-significant trends in strength and function. The pearl covers reviewing opioids in older adults.