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Review
. 2020 Jul 2:17:9.
doi: 10.1186/s11556-020-00240-y. eCollection 2020.

The effects of cognitive-motor training interventions on executive functions in older people: a systematic review and meta-analysis

Bettina Wollesen  1   2 , Alicia Wildbredt  1 , Kimberley S van Schooten  3   4 , Mei Ling Lim  3   4 , Kim Delbaere  3   4
Affiliations
Review

The effects of cognitive-motor training interventions on executive functions in older people: a systematic review and meta-analysis

Bettina Wollesen et al. Eur Rev Aging Phys Act. .

Abstract

Background: Ageing is associated with physical and cognitive decline, affecting independence and quality of life in older people. Recent studies show that in particular executive functions are important for daily-life function and mobility. This systematic review investigated the effectiveness of cognitive-motor training including exergaming on executive function (EF, set-shifting, working memory, inhibitory control) in healthy older people.

Methods: An electronic database search for randomised controlled trials (RCT), controlled clinical trials (CCT) and parallel group trials was performed using MEDLINE, EMBASE, and PsychINFO following PRISMA guidelines. Inclusion criteria were: (1) community-dwelling participants > 60 years without a medical condition or medical treatment, (2) reporting at least one cognitive-motor intervention while standing or walking, (3) use of dual-task interventions using traditional methods or modern technology to deliver a cognitive-motor task, (4) inclusion of at least one cognitive outcome. The PEDro scale was used for quality assessment.

Results: A total of 1557 studies were retrieved, of which 25 studies were included in this review. Eleven studies used a technology-based dual-task intervention, while 14 trials conducted a general cognitive-motor training. The age range of the cohort was 69 to 87 years. The interventions demonstrated positive effects on global cognitive function [mean difference 0.6, 95% CI 0.29-0.90] and inhibitory control [mean difference 0.61, 95% CI 0.28-0.94]. Effects were heterogeneous (I2 range: 60-95) and did not remain after a sensitivity analysis. Processing speed and dual-task costs also improved, but meta-analysis was not possible.

Conclusion: Cognitive-motor and technology-based interventions had a positive impact on some cognitive functions. Dual-task interventions led to improvements of domains related global cognitive functions and inhibitory control. Likewise, technology-based exergame interventions improved functions related to processing speed, attentional and inhibitory control. Training interventions with a certain level of exercise load such as progression in difficulty and task specificity were more effective to gain task-related adaptations on cognitive functions.

Keywords: Aged1; Cognitive function5; Dual-task2; Exergame3; Motor-cognitive intervention4.

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Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

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Fig. 1
Flow chart of study selection process
Fig. 2
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Training effects on global cognitive function
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Training effects on inhibitory control
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Training effects on working memory
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Training effects on cognitive flexibility
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