Dual-Task Exercise to Improve Cognition and Functional Capacity of Healthy Older Adults

Abstract

Background: It has been suggested that physical inactivity and lack of stimulating cognitive activity are the two most significant modifiable risk factors to impair cognitive function. Although many studies that investigated the cognitive effects of physical exercise and cognitive stimuli in dual-task conditions showed improved cognitive performance, others have not confirmed these findings. The main aim of the present work is to analyze the effects of a dual-task multimodal physical exercise training, at moderate intensity, and cognitive stimulation on cognitive and physical function in healthy older adults.

Methods: This clinical trial was registered on the Brazilian Registry of Clinical Trials (RBR-9zrx3d). Here we tested the effects of a dual-task multimodal physical exercise training, at moderate intensity, on cognitive and physical function and quality of life in community dwelling older adults. The training protocol included 24 group sessions, 2/week, per 75 min. Cognition was assessed using CANTAB automated neuropsychological tests and Functional Capacity to Exercise tests. Performance was compared from baseline to post intervention and to a non-exercise control group using Mixed Linear Model for repeated measures.

Results: Control (CG) and dual-task (DTEx) groups progressed differentially over time on performance of episodic memory, sustained visual attention, functional mobility, cardiorespiratory fitness, lower limbs strength resistance, agility, quality of life and dual-task performance with significant improved DTEx performance. Control group did not show any significant changes on these tests except for showing a reduction in dual-task performance.

Conclusion: We suggest that the dual-task combination of multisensory cognitive stimulation and multimodal moderate physical exercise training, twice a week, may be adopted as an effective program to reduce progression of age-related cognitive decline and improve physical fitness and quality of life on healthy older adults.

Clinical trial registration: Brazilian Registry of Clinical Trials: https://ensaiosclinicos.gov.br/rg/RBR-9zrx3d -UTN code: U1111-1233-6349.

Keywords: aged; cognitive dysfunction; dual-task exercise; healthy aging; neuropsychological tests; physical fitness; physical therapy modalities; rehabilitation.

FIGURE 1

Flow diagram of recruitment, allocation, intervention, and final sample included in data analysis.

FIGURE 2

Effect sizes (Z score) adjusted for age, education, and sex on cognitive function. Values are presented with mean ± SE. *p ≤ 0.05 (Effect size DTEx vs. Effect size CG). CERAD, consortium to establish a registry for Alzheimer’s disease; PAL, paired associates learning; RVP, rapid visual information processing; SE, standard error. (A–C) Episodic Memory. (D) Sustained Visual Attention. (E) Immediate Memory. (F) Evocation Memory. (G) Recognition Memory.

FIGURE 3

Dual task performance (Walking while Talking Test). Values presented as mean ± SE. ⁺p ≤ 0.05 (pre-test vs. pre-test); ^###p ≤ 0.001 (pos-test vs. pos-test); *p ≤ 0.05 (pre-test vs. pos-test). SE, standard error.

FIGURE 4

Dual Task Intervention effect sizes adjusted for age, education, and sex on Functional Exercise Capacity. Values are presented with mean ± SE. *p ≤ 0.05, **p ≤ 0.01, ***p ≤ 0.001 (Effect size DTEx vs. Effect Size CG).SE, standard error. (A) Cardiorespiratory Fitness. (B) Functional Mobility. (C) Lower Limbs Strength Resistance. (D) Agility. (E) Dual-Task Agility.