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Randomized Controlled Trial
. 2020 Mar 2;20(1):83.
doi: 10.1186/s12877-020-1484-5.

Effects of simultaneous cognitive and aerobic exercise training on dual-task walking performance in healthy older adults: results from a pilot randomized controlled trial

David A Raichlen  1 , Pradyumna K Bharadwaj  2   3 , Lauren A Nguyen  2   3 , Mary Kathryn Franchetti  2   3 , Erika K Zigman  2   3 , Abigail R Solorio  2   3 , Gene E Alexander  4   5   6   7   8   9   10
Affiliations
Randomized Controlled Trial

Effects of simultaneous cognitive and aerobic exercise training on dual-task walking performance in healthy older adults: results from a pilot randomized controlled trial

David A Raichlen et al. BMC Geriatr. .

Abstract

Background: The ability to walk and perform cognitive tasks simultaneously is a key aspect of daily life. Performance declines in these dual-tasks may be associated with early signs of neurodegenerative disease and increased risk of falls. Thus, interventions to improve dual-task walking performance are of great interest for promoting healthy aging. Here, we present results of a pilot randomized controlled trial (RCT) to evaluate the effects of a simultaneous aerobic exercise and cognitive training intervention on dual-task walking performance in healthy older adults.

Methods: Community-dwelling, healthy older adults were recruited to participate in a 12-week RCT. Participants were randomized into one of four groups (n = 74): 1) cognitive training (COG), 2) aerobic exercise (EX), 3) combined aerobic exercise and cognitive training (EXCOG), and 4) video-watching control (CON). The COG and EXCOG groups both used a tablet-based cognitive training program that challenged aspects of executive cognitive function, memory, and processing speed. Performance on a dual-task walking test (DTWT; serial subtraction during two-minute walk) was assessed by researchers blinded to groupings before the intervention, and at 6 and 12 weeks. We included all participants randomized with baseline measurements in an intention to treat analysis using linear mixed effects models.

Results: We found a significant group by time interaction for cognitive performance on the DTWT (p = 0.039). Specifically, participants in the EXCOG, EX, and COG groups significantly improved on the cognitive aspect of the DTWT following the full 12-week intervention (p = 3.5e-7, p = 0.048, p = 0.048, respectively). The improvements in EXCOG were twice as large as in the other groups, and were significant at 6 weeks (p = 0.019). The CON group did not show a significant change in cognitive performance on the DTWT, and no group significantly altered dual-task gait measures following the intervention.

Conclusions: A simultaneous aerobic exercise and cognitive training intervention significantly improved cognitive performance during a DTWT in healthy older adults. Despite no change in DTWT gait measures, significant improvements in cognitive performance indicate that further investigation in a larger RCT is warranted.

Trial registration: Clinicaltrials.gov, NCT04120792, Retrospectively Registered 08 October 2019.

Keywords: Aging; Cognition; Executive function; Exergame; Physical activity.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of screening, randomization, intervention, and data analysis
Fig. 2
Fig. 2
Cognitive performance across time and group. There was a significant interaction between group and time (p = 0.039). In post-hoc comparisons, EXCOG (combined exercise and cognitive training) showed significant improvements in the number of correct answers given during the 2-min dual task walking test. EX (exercise only) and COG (cognitive training only) each showed significant, but more modest, improvements only after the full 12-week intervention, CON (video-watching control) showed no significant improvements across any time points. P-values shown are corrected for multiple comparisons using FDR, p < 0.05. Error bars are SE of the mean
See this image and copyright information in PMC

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