The Impact of Aerobic Activity Programs on Quality of Life and Cardiovascular Fitness in the Elderly: A Review
DOI:
https://doi.org/10.22225/wmj.10.1.10603.48-58Kata Kunci:
Aerobic, Elderly, Cardiovascular Fitness, Preventive, Quality of LifeAbstrak
Aerobic activity is a gradual and targeted activity designed to enhance the body's ability to utilize cardiac and respiratory capacity (oxygen) effectively in the elderly. The growing number of elderly people and their long-term effects on psychological factors affecting their quality of life. This review aims to evaluate and synthesize scientific evidence on the effects of aerobic activity programs on quality of life and cardiovascular fitness in the elderly. This analysis uses the Preferred Reporting for Systematic Review and Meta-analysis (PRISMA) method. A systematic search was conducted by searching the Cochrane Database of Systematic Reviews, Embase, and Pubmed, independently using the terms "Aerobic", "Elderly", "Cardiovascular fitness", "Prevention", "Quality of life", "QoL", "exercise", "training", "sports", and "Physical". A total of 11 studies were included, demonstrating that engagement in aerobic physical activity leads to significant improvements in various health parameters among the elderly. These enhancements encompass cardiovascular health, physical function, and emotional well-being. A moderate, measured aerobic exercise program integrated into a daily routine can greatly benefit the health and vitality of the elderly. Such activities improve cardiovascular health, enhance physical function, and boost mental and emotional well-being, contributing to a better quality of life as we age.
Referensi
1. Hanssen H, Streese L, Vilser W. Retinal vessel diameters and function in cardiovascular risk and disease. Prog Retin Eye Res [Internet]. 2022;91(June):101095. Available from: https://doi.org/10.1016/j.preteyeres.2022.101095
2. Hoffmann CM, Petrov ME, Lee RE. Aerobic physical activity to improve memory and executive function in sedentary adults without cognitive impairment: A systematic review and meta-analysis. Prev Med Reports [Internet]. 2021;23(July):101496. Available from: https://doi.org/10.1016/j.pmedr.2021.101496
3. Vasankari V, Halonen J, Vasankari T, Anttila V, Airaksinen J, Sievänen H, et al. Physical activity and sedentary behaviour in secondary prevention of coronary artery disease: A review. Am J Prev Cardiol. 2021;5(July 2020):4–11.
4. Lewis CB, Laflin M, Gray DL. Exercise as Medicine for Older Women. Clin Geriatr Med. 2021;37(4):639–50.
5. Cheung B. The intersection of the two complimentary fields of preventive cardiology and integrative cardiology: A Fellow’s voice. Am J Prev Cardiol [Internet]. 2022;12(November):100433. Available from: https://doi.org/10.1016/j.ajpc.2022.100433
6. Kim YJ, Kim HJ, Lee SG, Kim DH, In Jang S, Go HS, et al. Aerobic exercise for eight weeks provides protective effects towards liver and cardiometabolic health and adipose tissue remodeling under metabolic stress for one week: A study in mice. Metabolism [Internet]. 2022;130(November 2021):155178. Available from: https://doi.org/10.1016/j.metabol.2022.155178
7. Bays HE, Khera A, Blaha MJ, Budoff MJ, Toth PP. Ten things to know about ten imaging studies: A preventive cardiology perspective (“ASPC top ten imaging”). Am J Prev Cardiol [Internet]. 2021;6(March):100176. Available from: https://doi.org/10.1016/j.ajpc.2021.100176
8. Hritani R. Heart healthy diet: A modifiable tool for cardiovascular disease prevention. Am J Prev Cardiol [Internet]. 2021;8(October):100287. Available from: https://doi.org/10.1016/j.ajpc.2021.100287
9. Esmail A, Vrinceanu T, Lussier M, Predovan D, Berryman N, Houle J, et al. Effects of Dance/Movement Training vs. Aerobic Exercise Training on cognition, physical fitness and quality of life in older adults: A randomized controlled trial. J Bodyw Mov Ther. 2020;24(1):212–20.
10. Wang Q, Zhou W. Roles and molecular mechanisms of physical exercise in cancer prevention and treatment. J Sport Heal Sci [Internet]. 2021;10(2):201–10. Available from: https://doi.org/10.1016/j.jshs.2020.07.008
11. Zhang S, Xiang K, Li S, Pan HF. Physical activity and depression in older adults: the knowns and unknowns. Psychiatry Res [Internet]. 2021;297(June 2020):113738. Available from: https://doi.org/10.1016/j.psychres.2021.113738
12. Liu Y, Avello M. Status of the research in fitness apps: A bibliometric analysis. Telemat Informatics [Internet]. 2021;57(July 2020):101506. Available from: https://doi.org/10.1016/j.tele.2020.101506
13. Lindgren M, Börjesson M. The importance of physical activity and cardiorespiratory fitness for patients with heart failure. Diabetes Res Clin Pract. 2021;176.
14. Wu Y, Johnson BT, Chen S, Chen Y, Livingston J, Pescatello LS. Tai Ji Quan as antihypertensive lifestyle therapy: A systematic review and meta-analysis. J Sport Heal Sci. 2021;10(2):211–21.
15. Wang X, Wu J, Ye M, Wang L, Zheng G. Effect of Baduanjin exercise on the cognitive function of middle-aged and older adults: A systematic review and meta-analysis. Complement Ther Med [Internet]. 2021;59(March):102727. Available from: https://doi.org/10.1016/j.ctim.2021.102727
16. Rojer AGM, Ramsey KA, Amaral Gomes ES, D’Andrea L, Chen C, Szoeke C, et al. Objectively assessed physical activity and sedentary behavior and global cognitive function in older adults: a systematic review. Mech Ageing Dev [Internet]. 2021;198(March):111524. Available from: https://doi.org/10.1016/j.mad.2021.111524
17. Warden BA, Purnell JQ, Duell PB, Craigan C, Osborn D, Cabot E, et al. Real-world utilization of pharmacotherapy with new evidence-based cardiovascular indications in an academic preventive cardiology practice. Am J Prev Cardiol [Internet]. 2021;5(November 2020):100144. Available from: https://doi.org/10.1016/j.ajpc.2020.100144
18. Saatmann N, Zaharia OP, Loenneke JP, Roden M, Pesta DH. Effects of Blood Flow Restriction Exercise and Possible Applications in Type 2 Diabetes. Trends Endocrinol Metab [Internet]. 2021;32(2):106–17. Available from: https://doi.org/10.1016/j.tem.2020.11.010
19. Leitzmann M, Powers H, Anderson AS, Scoccianti C, Berrino F, Boutron-Ruault MC, et al. European Code against Cancer 4th Edition: Physical activity and cancer. Cancer Epidemiol [Internet]. 2015;39:S46–55. Available from: http://dx.doi.org/10.1016/j.canep.2015.03.009
20. Hart JK, Michael P, Hawkins R, Bull ER, Farrar A, Baguley C, et al. ‘We just need to find space for them to practice so that we can help to make a stronger society’: Perceived barriers and facilitators to employing health psychologists in UK public health and clinical health settings. Br J Health Psychol. 2023;28(4):1206–21.
21. da Silva RP, Del Duca GF, Delevatti RS, Streb AR, Malta DC. Association between characteristics of physical activity in leisure time and obesity in Brazilians adults and elderly. Obes Res Clin Pract [Internet]. 2021;15(1):37–41. Available from: https://doi.org/10.1016/j.orcp.2020.11.004
22. de Bruijn AGM, van der Fels IMJ, Renken RJ, Königs M, Meijer A, Oosterlaan J, et al. Differential effects of long-term aerobic versus cognitively-engaging physical activity on children’s visuospatial working memory related brain activation: A cluster RCT. Brain Cogn. 2021;155(August).
23. Abbas MJ, Dancy ME, Marigi EM, Khalil LS, Jildeh TR, Buckley PJ, et al. An Automated Technique for the Measurement of Limb Occlusion Pressure During Blood Flow Restriction Therapy Is Equivalent to Previous Gold Standard. Arthrosc Sport Med Rehabil. 2022;4(3):e1127–32.
24. Porter GC, Schwab R, Hill JL, Bartee T, Heelan KA, Michaud TL, et al. Examining the feasibility and characteristics of realistic weight management support for patients: Focus groups with rural, micropolitan, and metropolitan primary care providers. Prev Med Reports [Internet]. 2021;23(April):101390. Available from: https://doi.org/10.1016/j.pmedr.2021.101390
25. Torma F, Gombos Z, Fridvalszki M, Langmar G, Tarcza Z, Merkely B, et al. Blood flow restriction in human skeletal muscle during rest periods after high-load resistance training down-regulates miR-206 and induces Pax7. J Sport Heal Sci [Internet]. 2021;10(4):470–7. Available from: https://doi.org/10.1016/j.jshs.2019.08.004
26. Fitriana LA, Darmawati I, Nasution LA, Putri ST, Rohaedi S, Anggadiredja K, et al. Effect of Centella Asiatica and Aerobic Exercise in Older Women With Dementia: A Randomized Controlled Trial. Malaysian J Med Heal Sci. 2021;17:153-60.
27. Xu L, Gu H, Cai X, Zhang Y, Hou X, Yu J, et al. The Effects of Exercise for Cognitive Function in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Int J Environ Res Public Health. 2023;20(2).
28. Latino F, Tafuri F. Physical Activity and Cognitive Functioning. Med. 2024;60(2):1–16.
29. Permadi AW. The Benefits of Aerobic Activity to Impact on Improving Quality of Life: A Critical Review of Study. Warmadewa Med J. 2019;(7):7-10
1. Hanssen H, Streese L, Vilser W. Retinal vessel diameters and function in cardiovascular risk and disease. Prog Retin Eye Res [Internet]. 2022;91(June):101095. Available from: https://doi.org/10.1016/j.preteyeres.2022.101095
2. Hoffmann CM, Petrov ME, Lee RE. Aerobic physical activity to improve memory and executive function in sedentary adults without cognitive impairment: A systematic review and meta-analysis. Prev Med Reports [Internet]. 2021;23(July):101496. Available from: https://doi.org/10.1016/j.pmedr.2021.101496
3. Vasankari V, Halonen J, Vasankari T, Anttila V, Airaksinen J, Sievänen H, et al. Physical activity and sedentary behaviour in secondary prevention of coronary artery disease: A review. Am J Prev Cardiol. 2021;5(July 2020):4–11.
4. Lewis CB, Laflin M, Gray DL. Exercise as Medicine for Older Women. Clin Geriatr Med. 2021;37(4):639–50.
5. Cheung B. The intersection of the two complimentary fields of preventive cardiology and integrative cardiology: A Fellow’s voice. Am J Prev Cardiol [Internet]. 2022;12(November):100433. Available from: https://doi.org/10.1016/j.ajpc.2022.100433
6. Kim YJ, Kim HJ, Lee SG, Kim DH, In Jang S, Go HS, et al. Aerobic exercise for eight weeks provides protective effects towards liver and cardiometabolic health and adipose tissue remodeling under metabolic stress for one week: A study in mice. Metabolism [Internet]. 2022;130(November 2021):155178. Available from: https://doi.org/10.1016/j.metabol.2022.155178
7. Bays HE, Khera A, Blaha MJ, Budoff MJ, Toth PP. Ten things to know about ten imaging studies: A preventive cardiology perspective (“ASPC top ten imaging”). Am J Prev Cardiol [Internet]. 2021;6(March):100176. Available from: https://doi.org/10.1016/j.ajpc.2021.100176
8. Hritani R. Heart healthy diet: A modifiable tool for cardiovascular disease prevention. Am J Prev Cardiol [Internet]. 2021;8(October):100287. Available from: https://doi.org/10.1016/j.ajpc.2021.100287
9. Esmail A, Vrinceanu T, Lussier M, Predovan D, Berryman N, Houle J, et al. Effects of Dance/Movement Training vs. Aerobic Exercise Training on cognition, physical fitness and quality of life in older adults: A randomized controlled trial. J Bodyw Mov Ther. 2020;24(1):212–20.
10. Wang Q, Zhou W. Roles and molecular mechanisms of physical exercise in cancer prevention and treatment. J Sport Heal Sci [Internet]. 2021;10(2):201–10. Available from: https://doi.org/10.1016/j.jshs.2020.07.008
11. Zhang S, Xiang K, Li S, Pan HF. Physical activity and depression in older adults: the knowns and unknowns. Psychiatry Res [Internet]. 2021;297(June 2020):113738. Available from: https://doi.org/10.1016/j.psychres.2021.113738
12. Liu Y, Avello M. Status of the research in fitness apps: A bibliometric analysis. Telemat Informatics [Internet]. 2021;57(July 2020):101506. Available from: https://doi.org/10.1016/j.tele.2020.101506
13. Lindgren M, Börjesson M. The importance of physical activity and cardiorespiratory fitness for patients with heart failure. Diabetes Res Clin Pract. 2021;176.
14. Wu Y, Johnson BT, Chen S, Chen Y, Livingston J, Pescatello LS. Tai Ji Quan as antihypertensive lifestyle therapy: A systematic review and meta-analysis. J Sport Heal Sci. 2021;10(2):211–21.
15. Wang X, Wu J, Ye M, Wang L, Zheng G. Effect of Baduanjin exercise on the cognitive function of middle-aged and older adults: A systematic review and meta-analysis. Complement Ther Med [Internet]. 2021;59(March):102727. Available from: https://doi.org/10.1016/j.ctim.2021.102727
16. Rojer AGM, Ramsey KA, Amaral Gomes ES, D’Andrea L, Chen C, Szoeke C, et al. Objectively assessed physical activity and sedentary behavior and global cognitive function in older adults: a systematic review. Mech Ageing Dev [Internet]. 2021;198(March):111524. Available from: https://doi.org/10.1016/j.mad.2021.111524
17. Warden BA, Purnell JQ, Duell PB, Craigan C, Osborn D, Cabot E, et al. Real-world utilization of pharmacotherapy with new evidence-based cardiovascular indications in an academic preventive cardiology practice. Am J Prev Cardiol [Internet]. 2021;5(November 2020):100144. Available from: https://doi.org/10.1016/j.ajpc.2020.100144
18. Saatmann N, Zaharia OP, Loenneke JP, Roden M, Pesta DH. Effects of Blood Flow Restriction Exercise and Possible Applications in Type 2 Diabetes. Trends Endocrinol Metab [Internet]. 2021;32(2):106–17. Available from: https://doi.org/10.1016/j.tem.2020.11.010
19. Leitzmann M, Powers H, Anderson AS, Scoccianti C, Berrino F, Boutron-Ruault MC, et al. European Code against Cancer 4th Edition: Physical activity and cancer. Cancer Epidemiol [Internet]. 2015;39:S46–55. Available from: http://dx.doi.org/10.1016/j.canep.2015.03.009
20. Hart JK, Michael P, Hawkins R, Bull ER, Farrar A, Baguley C, et al. ‘We just need to find space for them to practice so that we can help to make a stronger society’: Perceived barriers and facilitators to employing health psychologists in UK public health and clinical health settings. Br J Health Psychol. 2023;28(4):1206–21.
21. da Silva RP, Del Duca GF, Delevatti RS, Streb AR, Malta DC. Association between characteristics of physical activity in leisure time and obesity in Brazilians adults and elderly. Obes Res Clin Pract [Internet]. 2021;15(1):37–41. Available from: https://doi.org/10.1016/j.orcp.2020.11.004
22. de Bruijn AGM, van der Fels IMJ, Renken RJ, Königs M, Meijer A, Oosterlaan J, et al. Differential effects of long-term aerobic versus cognitively-engaging physical activity on children’s visuospatial working memory related brain activation: A cluster RCT. Brain Cogn. 2021;155(August).
23. Abbas MJ, Dancy ME, Marigi EM, Khalil LS, Jildeh TR, Buckley PJ, et al. An Automated Technique for the Measurement of Limb Occlusion Pressure During Blood Flow Restriction Therapy Is Equivalent to Previous Gold Standard. Arthrosc Sport Med Rehabil. 2022;4(3):e1127–32.
24. Porter GC, Schwab R, Hill JL, Bartee T, Heelan KA, Michaud TL, et al. Examining the feasibility and characteristics of realistic weight management support for patients: Focus groups with rural, micropolitan, and metropolitan primary care providers. Prev Med Reports [Internet]. 2021;23(April):101390. Available from: https://doi.org/10.1016/j.pmedr.2021.101390
25. Torma F, Gombos Z, Fridvalszki M, Langmar G, Tarcza Z, Merkely B, et al. Blood flow restriction in human skeletal muscle during rest periods after high-load resistance training down-regulates miR-206 and induces Pax7. J Sport Heal Sci [Internet]. 2021;10(4):470–7. Available from: https://doi.org/10.1016/j.jshs.2019.08.004
26. Fitriana LA, Darmawati I, Nasution LA, Putri ST, Rohaedi S, Anggadiredja K, et al. Effect of Centella Asiatica and Aerobic Exercise in Older Women With Dementia: A Randomized Controlled Trial. Malaysian J Med Heal Sci. 2021;17:153–60.
27. Xu L, Gu H, Cai X, Zhang Y, Hou X, Yu J, et al. The Effects of Exercise for Cognitive Function in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Int J Environ Res Public Health. 2023;20(2).
28. Latino F, Tafuri F. Physical Activity and Cognitive Functioning. Med. 2024;60(2):1–16.
29. Permadi AW. The benefits of aerobic activitiy to impact on improving quality of life: A Critical Riview of Study. Warmadewa Med J. 2019;(7):7–10.
30. Weaver AN, Jaeggi SM. Activity Engagement and Cognitive Performance Amongst Older Adults. Front Psychol. 2021;12(March):1–12.
1. Hanssen H, Streese L, Vilser W. Retinal vessel diameters and function in cardiovascular risk and disease. Prog Retin Eye Res [Internet]. 2022;91(June):101095. Available from: https://doi.org/10.1016/j.preteyeres.2022.101095
2. Hoffmann CM, Petrov ME, Lee RE. Aerobic physical activity to improve memory and executive function in sedentary adults without cognitive impairment: A systematic review and meta-analysis. Prev Med Reports [Internet]. 2021;23(July):101496. Available from: https://doi.org/10.1016/j.pmedr.2021.101496
3. Vasankari V, Halonen J, Vasankari T, Anttila V, Airaksinen J, Sievänen H, et al. Physical activity and sedentary behaviour in secondary prevention of coronary artery disease: A review. Am J Prev Cardiol. 2021;5(July 2020):4–11.
4. Lewis CB, Laflin M, Gray DL. Exercise as Medicine for Older Women. Clin Geriatr Med. 2021;37(4):639–50.
5. Cheung B. The intersection of the two complimentary fields of preventive cardiology and integrative cardiology: A Fellow’s voice. Am J Prev Cardiol [Internet]. 2022;12(November):100433. Available from: https://doi.org/10.1016/j.ajpc.2022.100433
6. Kim YJ, Kim HJ, Lee SG, Kim DH, In Jang S, Go HS, et al. Aerobic exercise for eight weeks provides protective effects towards liver and cardiometabolic health and adipose tissue remodeling under metabolic stress for one week: A study in mice. Metabolism [Internet]. 2022;130(November 2021):155178. Available from: https://doi.org/10.1016/j.metabol.2022.155178
7. Bays HE, Khera A, Blaha MJ, Budoff MJ, Toth PP. Ten things to know about ten imaging studies: A preventive cardiology perspective (“ASPC top ten imaging”). Am J Prev Cardiol [Internet]. 2021;6(March):100176. Available from: https://doi.org/10.1016/j.ajpc.2021.100176
8. Hritani R. Heart healthy diet: A modifiable tool for cardiovascular disease prevention. Am J Prev Cardiol [Internet]. 2021;8(October):100287. Available from: https://doi.org/10.1016/j.ajpc.2021.100287
9. Esmail A, Vrinceanu T, Lussier M, Predovan D, Berryman N, Houle J, et al. Effects of Dance/Movement Training vs. Aerobic Exercise Training on cognition, physical fitness and quality of life in older adults: A randomized controlled trial. J Bodyw Mov Ther. 2020;24(1):212–20.
10. Wang Q, Zhou W. Roles and molecular mechanisms of physical exercise in cancer prevention and treatment. J Sport Heal Sci [Internet]. 2021;10(2):201–10. Available from: https://doi.org/10.1016/j.jshs.2020.07.008
11. Zhang S, Xiang K, Li S, Pan HF. Physical activity and depression in older adults: the knowns and unknowns. Psychiatry Res [Internet]. 2021;297(June 2020):113738. Available from: https://doi.org/10.1016/j.psychres.2021.113738
12. Liu Y, Avello M. Status of the research in fitness apps: A bibliometric analysis. Telemat Informatics [Internet]. 2021;57(July 2020):101506. Available from: https://doi.org/10.1016/j.tele.2020.101506
13. Lindgren M, Börjesson M. The importance of physical activity and cardiorespiratory fitness for patients with heart failure. Diabetes Res Clin Pract. 2021;176.
14. Wu Y, Johnson BT, Chen S, Chen Y, Livingston J, Pescatello LS. Tai Ji Quan as antihypertensive lifestyle therapy: A systematic review and meta-analysis. J Sport Heal Sci. 2021;10(2):211–21.
15. Wang X, Wu J, Ye M, Wang L, Zheng G. Effect of Baduanjin exercise on the cognitive function of middle-aged and older adults: A systematic review and meta-analysis. Complement Ther Med [Internet]. 2021;59(March):102727. Available from: https://doi.org/10.1016/j.ctim.2021.102727
16. Rojer AGM, Ramsey KA, Amaral Gomes ES, D’Andrea L, Chen C, Szoeke C, et al. Objectively assessed physical activity and sedentary behavior and global cognitive function in older adults: a systematic review. Mech Ageing Dev [Internet]. 2021;198(March):111524. Available from: https://doi.org/10.1016/j.mad.2021.111524
17. Warden BA, Purnell JQ, Duell PB, Craigan C, Osborn D, Cabot E, et al. Real-world utilization of pharmacotherapy with new evidence-based cardiovascular indications in an academic preventive cardiology practice. Am J Prev Cardiol [Internet]. 2021;5(November 2020):100144. Available from: https://doi.org/10.1016/j.ajpc.2020.100144
18. Saatmann N, Zaharia OP, Loenneke JP, Roden M, Pesta DH. Effects of Blood Flow Restriction Exercise and Possible Applications in Type 2 Diabetes. Trends Endocrinol Metab [Internet]. 2021;32(2):106–17. Available from: https://doi.org/10.1016/j.tem.2020.11.010
19. Leitzmann M, Powers H, Anderson AS, Scoccianti C, Berrino F, Boutron-Ruault MC, et al. European Code against Cancer 4th Edition: Physical activity and cancer. Cancer Epidemiol [Internet]. 2015;39:S46–55. Available from: http://dx.doi.org/10.1016/j.canep.2015.03.009
20. Hart JK, Michael P, Hawkins R, Bull ER, Farrar A, Baguley C, et al. ‘We just need to find space for them to practice so that we can help to make a stronger society’: Perceived barriers and facilitators to employing health psychologists in UK public health and clinical health settings. Br J Health Psychol. 2023;28(4):1206–21.
21. da Silva RP, Del Duca GF, Delevatti RS, Streb AR, Malta DC. Association between characteristics of physical activity in leisure time and obesity in Brazilians adults and elderly. Obes Res Clin Pract [Internet]. 2021;15(1):37–41. Available from: https://doi.org/10.1016/j.orcp.2020.11.004
22. de Bruijn AGM, van der Fels IMJ, Renken RJ, Königs M, Meijer A, Oosterlaan J, et al. Differential effects of long-term aerobic versus cognitively-engaging physical activity on children’s visuospatial working memory related brain activation: A cluster RCT. Brain Cogn. 2021;155(August).
23. Abbas MJ, Dancy ME, Marigi EM, Khalil LS, Jildeh TR, Buckley PJ, et al. An Automated Technique for the Measurement of Limb Occlusion Pressure During Blood Flow Restriction Therapy Is Equivalent to Previous Gold Standard. Arthrosc Sport Med Rehabil. 2022;4(3):e1127–32.
24. Porter GC, Schwab R, Hill JL, Bartee T, Heelan KA, Michaud TL, et al. Examining the feasibility and characteristics of realistic weight management support for patients: Focus groups with rural, micropolitan, and metropolitan primary care providers. Prev Med Reports [Internet]. 2021;23(April):101390. Available from: https://doi.org/10.1016/j.pmedr.2021.101390
25. Torma F, Gombos Z, Fridvalszki M, Langmar G, Tarcza Z, Merkely B, et al. Blood flow restriction in human skeletal muscle during rest periods after high-load resistance training down-regulates miR-206 and induces Pax7. J Sport Heal Sci [Internet]. 2021;10(4):470–7. Available from: https://doi.org/10.1016/j.jshs.2019.08.004
26. Fitriana LA, Darmawati I, Nasution LA, Putri ST, Rohaedi S, Anggadiredja K, et al. Effect of Centella Asiatica and Aerobic Exercise in Older Women With Dementia: A Randomized Controlled Trial. Malaysian J Med Heal Sci. 2021;17:153–60.
27. Xu L, Gu H, Cai X, Zhang Y, Hou X, Yu J, et al. The Effects of Exercise for Cognitive Function in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Int J Environ Res Public Health. 2023;20(2).
28. Latino F, Tafuri F. Physical Activity and Cognitive Functioning. Med. 2024;60(2):1–16.
29. Permadi AW. The benefits of aerobic activitiy to impact on improving quality of life: A Critical Riview of Study. Warmadewa Med J. 2019;(7):7–10.
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