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Randomized Controlled Trial
. 2024;100(1):175-192.
doi: 10.3233/JAD-231257.

Effects of 6-Month Combined Physical Exercise and Cognitive Training on Neuropsychological and Neurophysiological Function in Older Adults with Subjective Cognitive Decline: A Randomized Controlled Trial

Chia-Hsiung Cheng  1   2   3   4 , Yu-Wei Hsieh  1   5 , Chiung-Chih Chang  6 , Fu-Jung Hsiao  7 , Li-Fen Chen  8 , Pei-Ning Wang  9
Affiliations
Randomized Controlled Trial

Effects of 6-Month Combined Physical Exercise and Cognitive Training on Neuropsychological and Neurophysiological Function in Older Adults with Subjective Cognitive Decline: A Randomized Controlled Trial

Chia-Hsiung Cheng et al. J Alzheimers Dis. 2024.

Abstract

Background: Multidomain intervention may delay or ameliorate cognitive decline in older adults at risk of Alzheimer's disease, particularly in the memory and inhibitory functions. However, no study systematically investigates the changes of brain function in cognitively-normal elderly with subjective cognitive decline (SCD) when they receive multidomain intervention.

Objective: We aimed to examine whether a multidomain intervention could improve neuropsychological function and neurophysiological activities related to memory and inhibitory function in SCD subjects.

Methods: Eight clusters with a total of 50 community-dwelling SCD older adults were single-blind, randomized into intervention group, which received physical and cognitive training, or control group, which received treatment as usual. For the neuropsychological function, a composite Z score from six cognitive tests was calculated and compared between two groups. For the neurophysiological activities, event-related potentials (ERPs) of memory function, including mismatch negativity (MMN) and memory-P3, as well as ERPs of inhibitory function, including sensory gating (SG) and inhibition-P3, were measured. Assessments were performed at baseline (T1), end of the intervention (T2), and 6 months after T2 (T3).

Results: For the neuropsychological function, the effect was not observed after the intervention. For the neurophysiological activities, improved MMN responses of ΔT2-T1 were observed in the intervention group versus the control group. The multidomain intervention produced a sustained effect on memory-P3 latencies of ΔT3-T1. However, there were no significant differences in changes of SG and inhibition-P3 between intervention and control groups.

Conclusions: While not impactful on neuropsychological function, multidomain intervention enhances specific neurophysiological activities associated with memory function.

Keywords: Alzheimer’s disease; P3; event-related potential; lifestyle intervention; mismatch negativity; multidomain intervention; occupational therapy.

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Conflict of interest statement

The authors have no conflict of interest to report.

Figures

Fig. 1
Fig. 1
Flowchart of participants.
Fig. 2
Fig. 2
A) Grand-averaged waveforms of mismatch negativity (MMN) at Fz electrode in the intervention (n = 21) and control (n = 13) groups. The black, blue, and red traces indicate MMN activities at the baseline (T1), the end of the intervention (T2), and 6 months after the end of the intervention (T3), respectively. The topographic maps of peak MMN latencies at T1, T2, and T3 in each group are also illustrated. B) Larger MMN amplitudes (indicated by more negative values) and shortened MMN latencies (also indicated by more negative values) of ΔT2–T1 were observed in the intervention group as compared to the control group. The MMN amplitudes and latencies of ΔT3–T1 were not significantly different between these two groups.
Fig. 3
Fig. 3
A) Grand-averaged waveforms of P3 responses to the targets (i.e., memory-P3) during a 1-back task at Pz electrode in the intervention (n = 21) and control (n = 13) groups. The black, blue, and red traces indicate memory-P3 activities at the baseline (T1), the end of the intervention (T2), and 6 months after the end of the intervention (T3), respectively. The topographic maps of peak memory-P3 latencies at T1, T2, and T3 in each group are also illustrated. B) Significantly shortened memory-P3 latencies of ΔT3–T1 were observed in the intervention group as compared to the control group.
Fig. 4
Fig. 4
Left: Among the SCD subjects in the intervention group, more shortening of the memory-P3 latencies from T1 to T3 was significantly associated with more gains in raw scores of LM_Immediate from T1 to T3 (partial r = -0.576, p = 0.006, FDR = 0.042). Right: A similar pattern was also observed in the association between changes in memory-P3 latencies and changes in raw scores of LM_Delayed. However, the significance did not survive after the correction for multiple comparisons though a trend-level of significance (p = 0.015, FDR = 0.053) was detected. SCD, subjective cognitive decline; LM, Logic Memory Test Part A of the Wechsler Memory Scale; FDR, false discovery rate.
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