Cognitive function, physical activity, and aging: possible biological links and implications for multimodal interventions.

Increasing evidence shows the positive effect of physical activity (PA) on maintaining cognitive function. Both processes seem intrinsically linked to each other. The most likely mechanism is a reciprocal stimulation of neuroplasticity. Based on extensive experimental work on animals and humans, the concept of an enriched environment, including PA and challenging cognitive tasks, has provided the basis to systematically assess possible interventions for successful aging. I will use recent findings on brain mechanisms associated with PA and its effects on higher cognitive function at a systems and molecular level to demonstrate the need to design effective interventions. Such interventions should be designed to take advantage of the presumed compensatory mechanisms of elderly individuals, thereby limiting functional decline in higher cognitive performance in aging people. My review of the most recent relevant publications concerning this topic supports the notion that it is a promising approach to provide cognitive training and PA in conjunction, since the combination may generate synergistic beneficial changes than either one individually. Multimodal training programs should therefore be tested. However, at present there is insufficient evidence to conclude that multimodal interventions are superior to isolated cognitive or physical exercise interventions, since major studies addressing this topic are lacking. These studies are needed to conclusively prove that both strategies will positively interact when used in combined interventions. Finally the use of modern technology for these interventions will be discussed.