Cognitive Improvement Following Physical Exercise and Cognitive Training Intervention for Older Adults With MCI

Abstract

Background: The diagnosis of mild cognitive impairment (MCI) presents a critical period for intervention. Although exercise and cognitive training (CT) interventions have reported independent success in improving cognition, some meta-analyses have suggested that combined interventions provide maximal benefits. Much previous research has studied land-based as opposed to water-based exercise, which places potential barriers on older adults. The purpose of the current study was to examine the impact of combined exercise (water- or land-based) and CT treatment on cognition for older adults with MCI.

Methods: Participants were 67 adults ages 54-86 years classified with MCI who engaged in 6 months of land or aquatic-based exercise with subsequent CT over 4 weeks. Primary outcome variables were performance measures of several cognitive domains across 3-time points (baseline, following exercise intervention, and following CT intervention). Linear mixed effects modeling examined exercise group differences across time periods in an intention-to-treat analysis.

Results: Both aquatic- and land-based exercise with CT interventions resulted in significant improvement in learning and memory outcomes, though improvement in executive functioning, processing speed, language, and visuospatial abilities was limited to water-based and CT treatment groups. Differences in linear growth patterns between groups were nonsignificant.

Conclusion: Results suggest that for older adults with MCI to obtain global cognitive benefits (ie, learning and memory, executive functioning, processing speed, language, and visuospatial abilities) using combined exercise and CT interventions, they must be able to fully engage in exercise, and aquatic-based activities should be further considered.

Keywords: Cognitive training; Learning and memory; Water-based exercise.

Figure 1.

Standardized mean change z-scores by intervention. Change in domain z-score by treatment condition by phase of intervention. Domain scores improved significantly in the land-based exercise + cognitive training and aquatic-based exercise + cognitive training conditions for learning and memory. Domain scores improved significantly for the executive function, processing speed, language, and visuospatial assessments for the WATER condition only. There was no additional significant change in scores across these domains for the land-based exercise condition. Values were calculated from change in domain z-scores from Time 1 to Time 2 (exercise phase) and Time 2 to Time 3 (cognitive training phase). CT = cognitive training; EF = executive function; ET = exercise training; LM = learning and memory; Land = land-based exercise + cognitive training; LNG = language; PS = processing speed; VSP = visuospatial; Water = water-based exercise + cognitive training.