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

Abstract

BackgroundIt 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.MethodsThis 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.ResultsControl (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.ConclusionWe 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 RegistrationBrazilian Registry of Clinical Trials: https://ensaiosclinicos.gov.br/rg/RBR-9zrx3d -UTN code: U1111-1233-6349.

A Review of Combined Training Studies in Older Adults According to a New Categorization of Conventional Interventions

“…Then, a second step consisted of identifying the studies published between November 2020 and August 2021 through similar systematic searches ("combined training" OR "cognitivemotor" OR "dual-task training" OR "multicomponent training" OR "multidomain training") AND ("older adults" OR "healthy older adults" AND "English"). Only one study (Jardim et al, 2021, published in February 2021 met the inclusion criteria.…”

“….) to physical/motor exercises through dual-task situations (see Jardim et al, 2021, Supplementary Table 1, for illustrative examples). Pre-intervention and postintervention tests were administered in all the studies.…”

“…The most frequently used tests to assess cognition were the MMSE (Pieramico et al, 2012;Nishiguchi et al, 2015;Yokoyama et al, 2015;Ansai et al, 2017), the clock drawing test (Pieramico et al, 2012;Ansai et al, 2017), TMT(A-B) (Pieramico et al, 2012;van het Reve and de Bruin, 2014;Eggenberger et al, 2015a;Nishiguchi et al, 2015;Yokoyama et al, 2015) and the Wechsler scale (Nishiguchi et al, 2015;Kalbe et al, 2018). Dual-task costs during walking or psychomotor reaction time were also assessed (van het Reve and de Bruin, 2014; Yokoyama et al, 2015;Ansai et al, 2017;Jardim et al, 2021). More attention to physical fitness (i.e., cardiorespiratory fitness, lower limbs strength, and agility), balance (single-leg standing), and mobility (maximal step length, Timed Up and Go, and Sit to Stand tests) were given in all the reviewed MDT studies than in PCT and MCT studies.…”

CogniViTra, a Digital Solution to Support Dual-Task Rehabilitation Training

“…Table 1 presents relevant studies [3,[51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] related to the use of digital solutions to support physical activities or cognitive and physical activities with different purposes (i.e., postural control and prevention of falls [51,53,54,58,59,65], assistance in physical exercises [52,56,61], physical activity adherence [55], improvement of physical performance [58][59][60]63,64], and improvement of cognitive performance [3,57,60,62,64]). The studies are supported in various types of technologies, namely exergames and virtual reality [51,53,54,[57][58][59][60][61][62][63]…”

Associations of Cognitive Complaints and Depressive Symptoms with Health-Related Quality of Life and Perceived Overall Health in Japanese Adult Volunteers

“…Cognitive function has attracted attention in the public health field in recent years [1][2][3][4]. Cognitive impairments have been assessed subjectively and objectively.…”