A non-pharmacological multidomain intervention of dual-task exercise and social activity affects the cognitive function in community-dwelling older adults with mild to moderate cognitive decline: A randomized controlled trial

Abstract

The present study aimed to determine the impact of a 10-month multidomain program using dual-task exercise and social activity conducted at a community-based facility on improved cognitive function in older adults with mild to moderate cognitive decline. The participants included 280 community-dwelling older adults (age 71-91 years) with mild to moderate cognitive decline. The intervention group exercised for 90 min/day, once a week. Their routine included aerobic exercise and dual-task training which cognitive tasks were performed in combination with exercise. The control group attended health education classes thrice. Before and after the intervention, we measured their cognitive function, physical function, daily conversation, and physical activity. The mean adherence rate of the intervention class was 83.0%. According to a repeated-measures multivariate analysis of covariance in an intent-to-treat analysis, logical memory and 6-min walking distance demonstrated a significant time and group interaction effect. Regarding daily physical activities, we observed significant differences in the daily step count and moderate-to-vigorous physical activity in the intervention group. Our non-pharmacological multidomain intervention resulted in a modest improvement in the cognitive or physical function and building health behavior. It may be a helpful program with a potential role in preventing dementia. Clinical Trial Registration: http://clinicaltrials.gov Identifier ID: UMIN000013097.

Keywords: cognitive decline; community-dwelling older adults; dual task; geriatric health; non-pharmacological multi-domain program; randomized control trial.

Figure 1

Flow diagram of the participants in the community-based lifestyle intervention program from the screening to the final follow-up assessment. MMSE, mini-mental state examination; MRI, magnetic resonance imaging.

Figure 2

The mean performance of the intervention group (solid lines) and control group (dashed lines) at baseline and 10 months post-intervention after controlling for the covariates values of sex, age, education level, and the number of medications using the repeated-measures analysis of covariance. (Logical memory p = 0.026, 6MWT p < 0.001, average daily step p = 0.005, and MVPA p = 0.033). 6MWT, 6-min walking test; MVPA, moderate-to-vigorous physical activity. *p < 0.05, **p < 0.01, and ***p < 0.001.