Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up

Abstract

Background

Cognitive impairment is a health problem that concerns almost every second elderly person. Physical and cognitive training have differential positive effects on cognition, but have been rarely applied in combination. This study evaluates synergistic effects of multicomponent physical exercise complemented with novel simultaneous cognitive training on cognition in older adults. We hypothesized that simultaneous cognitive–physical components would add training specific cognitive benefits compared to exclusively physical training.

Methods

Seniors, older than 70 years, without cognitive impairment, were randomly assigned to either: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Cognitive performance was assessed at baseline, after 3 and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were calculated.

Results

Eighty-nine participants were randomized to the three groups initially, 71 completed the training, while 47 were available at 1-year follow-up. Advantages of the simultaneous cognitive–physical programs were found in two dimensions of executive function. “Shifting attention” showed a time×intervention interaction in favor of DANCE/MEMORY versus PHYS (F[2, 68] =1.95, trend P=0.075, r=0.17); and “working memory” showed a time×intervention interaction in favor of DANCE versus MEMORY (F[1, 136] =2.71, trend P=0.051, R²=0.006). Performance improvements in executive functions, long-term visual memory (episodic memory), and processing speed were maintained at follow-up in all groups.

Conclusion

Particular executive functions benefit from simultaneous cognitive–physical training compared to exclusively physical multicomponent training. Cognitive–physical training programs may counteract widespread cognitive impairments in the elderly.

Keywords:

• elderly
• executive function
• transfer
• cognitive impairment
• dance
• video game

Acknowledgments

This work was supported by the Zürcher Kantonalbank within the framework of sponsoring of movement sciences, sports, and nutritional sciences at ETH Zurich. Zürcher Kantonal-bank had no influence on the study design and the analyses presented in this paper, had no access to the data, and did not contribute to this manuscript in any way. The authors would like to thank PD Dr med. Thomas Münzer, chief physician, and the management of Geriatrische Klinik St Gallen, Switzerland, for supporting the study and providing room for training and data acquisition. Furthermore, we thank our postgraduate students, Stefan Holenstein, Fabienne Hüppin, Manuela Kobelt, Alexandra Schättin, and Sara Tomovic for training instruction and helping with data acquisition. We highly appreciate the support of the team of physiotherapists at Geriatrische Klinik St Gallen, and particularly the support from Carmen Fürer and Carole Scheidegger who initially put forward the idea of performing the study at their institution. Last but not the least, we would like to thank all the participants for their enthusiasm, kindness, and patience during our extensive training and testing interventions.

Author contributions

PE, study preparation and conception, participants’ recruitment, data acquisition, statistical analysis, data interpretation, drafting manuscript; VS, study conception, conception of cognitive test battery, data interpretation, revising manuscript; MA, study preparation, training instruction, data acquisition, data interpretation, revising manuscript; NT, study conception, conception of serial position training, supporting statistical analysis, data interpretation, revising manuscript; EDB, study conception, data interpretation, revising manuscript. All authors read and approved the final manuscript.

Disclosure

The authors report no conflicts of interest in this work.