Effects of combined physical and cognitive training on fitness and neuropsychological outcomes in healthy older adults

Figures & data

Table 1 Baseline characteristics of participants

Characteristics	AR training (n=38)		ST exercises (n=38)		P-value
	DT training (n=22)	CL (n=16)	DT training (n=20)	CL (n=18)	AR training vs ST exercises	DT training vs CL
Age (years)	72.7 (7.4)	70.9 (7.4)	73.2 (6.3)	72.5 (7.0)	0.521	0.452
Sex (Female/Male)	13/9	8/8	17/3	15/3	n/a	n/a
Education (years)	14.4 (2.8)	15.9 (2.1)	14.1 (4.3)	14.1 (3.8)	0.178	0.367
CVR (score)	2.1 (1.7)	1.7 (1.2)	2.5 (1.5)	2.3 (1.3)	0.153	0.365
GDS (score)	4.6 (3.3)	4.4 (2.6)	3.4 (3.2)	2.7 (2.9)	0.048*	0.574
Cognitive screening measures
MMSE (score)	28.8 (1.3)	28.8 (1.0)	29.4 (0.7)	28.5 (1.4)	0.616	0.128
Similarities (score)	23.4 (4.5)	22.2 (4.8)	22.0 (4.7)	22.3 (5.7)	0.548	0.694
Digit span-forward (score)	9.3 (1.8)	9.5 (1.9)	9.3 (2.4)	9.0 (2.5)	0.608	0.907
Digit span-backward (score)	6.1 (1.6)	6.6 (1.8)	7.0 (2.3)	5.9 (1.6)	0.773	0.461
DSST (score)	58.5 (12.1)	60.3 (18.7)	54.9 (13.1)	57.0 (14.9)	0.307	0.563

Notes: Data presented as mean (standard deviation) unless stated otherwise.

* P<0.05.

Abbreviations: AR, aerobic and resistance; CVR, cardiovascular risk; CL, computer lessons; DSST, digit symbol substitution test; DT, dual-task; GDS, geriatric depression scale; MMSE, mini-mental state evaluation; n/a, not available; ST, stretching and toning.

Table 2 Mean and SD of physical performance measures

Measures	AR training (n=38)				ST exercises (n=38)
	DT training (n=22)		CL (n=16)		DT training (n=20)		CL (n=18)
	Pre	Post	Pre	Post	Pre	Post	Pre	Post
Handgrip strength (kg)a,***	42.3 (16.4)	41.7 (19.3)	49.9 (15.8)	50.2 (16.0)	34.6 (10.5)	33.9 (9.9)	37.4 (12.8)	36.1 (10.3)
TUG (seconds)	6.9 (1.2)	6.2 (0.9)	6.6 (1.7)	6.2 (0.9)	7.5 (1.7)	7.0 (1.5)	6.7 (1.1)	6.1 (0.8)
Chair stands (nb)a,***;b,*;c,***;d,***	13.9 (3.3)	20.2 (5.2)	13.0 (2.9)	18.9 (7.3)	11.0 (3.4)	12.4 (3.5)	13.8 (3.9)	16.3 (5.2)
6-MWT (m)c,**	501.2 (68.7)	535.4 (71.7)	532.3 (74.3)	566.4 (91.8)	499.1 (85.9)	515.0 (77.8)	502.2 (69.7)	533.5 (64.3)
PPT (score)c,**	32.4 (2.4)	34.2 (1.9)	31.9 (3.5)	33.6 (1.8)	31.5 (2.1)	32.8 (2.1)	32.4 (2.8)	33.3 (3.2)

Notes: Data presented as mean (standard deviation).

a Physical training main effect;

b Physical training × cognitive training interaction;

c Time main effect;

d Time × physical training interaction:

* P<0.05;

** P<0.01;

*** P<0.001.

Abbreviations: AR, aerobic and resistance; CL, computer lessons; DT, dual-task; 6-MWT, 6-minute walk test; PPT, physical performance test; ST, stretching and toning; TUG, timed up and go.

Table 3 Mean and SD of neuropsychological measures

Measures	AR training (n=38)				ST exercises (n=38)
	DT training (n=22)		CL (n=16)		DT training (n=20)		CL (n=18)
	Pre	Post	Pre	Post	Pre	Post	Pre	Post
Memory
RAVLT-total 5 trials (nb)	50.3 (9.6)	47.4 (8.4)	47.6 (10.0)	47.8 (9.9)	51.3 (10.1)	48.7 (9.5)	52.3 (10.3)	51.9 (8.8)
RAVLT-immediate recall (nb)	10.2 (3.3)	8.9 (3.1)	10.3 (2.8)	8.8 (3.5)	10.6 (2.5)	10.0 (3.1)	10.9 (3.0)	9.8 (3.0)
RAVLT-delayed recall (nb)	10.6 (3.6)	9.2 (2.7)	9.6 (3.1)	9.4 (3.3)	11.2 (2.5)	9.8 (2.6)	11.8 (2.9)	10.4 (3.3)
Processing speed
CWIT-color naming (seconds)	31.6 (6.0)	31.6 (6.4)	32.7 (7.0)	33.2 (7.3)	32.4 (6.0)	30.6 (4.3)	32.9 (8.5)	32.9 (11.2)
CWIT-reading (seconds)	21.9 (3.1)	21.4 (2.8)	22.9 (4.6)	23.0 (4.5)	22.4 (3.0)	22.7 (3.2)	23.0 (3.9)	23.0 (4.5)
TMT-part A (seconds)a,**	39.2 (10.6)	34.8 (7.4)	36.4 (10.2)	35.3 (11.1)	43.8 (14.6)	37.1 (8.7)	38.7 (10.7)	37.1 (11.6)
BDT-single task (Xs)	161.6 (24.1)	168.6 (23.2)	152.1 (29.1)	156.7 (27.8)	155.3 (21.2)	160.2 (18.7)	155.1 (29.5)	160.6 (27.4)
Executive functions
CWIT-inhibition (seconds)a,*	61.1 (13.9)	59.2 (12.4)	62.9 (15.2)	60.5 (11.7)	68.3 (22.0)	64.6 (22.0)	67.7 (22.4)	64.2 (15.4)
CWIT-switching (seconds)b,**	68.1 (28.0)	63.8 (13.4)	61.7 (13.6)	64.9 (16.4)	71.3 (24.1)	66.0 (22.5)	65.8 (11.3)	67.6 (16.3)
TMT-part B (seconds)	95.0 (27.8)	90.8 (23.9)	84.6 (24.6)	80.4 (14.5)	95.8 (58.3)	90.1 (42.2)	89.0 (30.3)	96.6 (42.1)
BDT-DT index	45.9 (10.1)	43.2 (19.6)	39.3 (16.4)	45.5 (10.2)	43.7 (15.2)	48.5 (9.0)	45.8 (9.1)	46.8 (8.8)

Notes: Data presented as mean (standard deviation).

a Time main effect;

b Time × cognitive training interaction:

* P<0.05 and

** P<0.01.

Abbreviations: AR, aerobic and resistance; BDT, Baddeley DT; CL, computer lessons; CWIT, Color-Word Interference Test; DT, dual-task; nb, number of words; RAVLT, Rey Auditory-Verbal Learning Test; ST, stretching and toning; TMT, trail-making test; Xs, number of Xs.

Table 4 Summary of multiple hierarchical regression analyses predicting neuropsychological scores at posttest

Factors	Model 1			Model 2
	B	β	P-value	B	β	P-value
TMT-A (post)
Age	0.390	0.284	0.015*	0.303	0.221	0.090
Education	0.076	0.027	0.813	0.264	0.094	0.428
Sex	−0.529	−0.026	0.824	−1.032	−0.050	0.672
Chair stands				0.295	0.189	0.160
6-MWT				−0.004	−0.036	0.801
PPT				−1.206	−0.292	0.052
	R^2=0.082			R^2=0.148
	F=2.115			ΔR^2=0.066
				F=1.964
CWIT-inhibition (post)
Age	0.604	0.264	0.022*	0.409	0.178	0.168
Education	−0.699	−0.149	0.192	−0.595	−0.127	0.283
Sex	3.322	0.097	0.395	5.239	0.153	0.198
Chair stands				−0.260	−0.100	0.454
6-MWT				−0.046	−0.222	0.116
PPT				0.594	0.087	0.557
	R^2=0.096			R^2=0.142
	F=2.535			ΔR^2=0.046
				F=1.899
CWIT-switching (post)
Age	1.153	0.466	0.000***	0.782	0.316	0.006**
Education	−0.859	−0.170	0.106	−0.504	−0.010	0.332
Sex	3.138	0.084	0.417	5.638	0.152	0.140
Chair stands				0.047	0.017	0.884
6-MWT				−0.082	−0.366	0.003**
PPT				−0.298	−0.040	0.753
	R^2=0.244			R^2=0.358
	F=7.729***			ΔR^2=0.114
				F=6.403***

Notes:

* P<0.05;

** P<0.01;

*** P<0.001.

Abbreviations: CWIT, Color-Word Interference Test; 6-MWT, 6-minute walk test; PPT, physical performance test; TMT-A, trail-making test-part A.