Effects of Combined Physical Movement Activity and Multifaceted Cognitive Training in Older People with Mild Neurocognitive Disorder in a Rural Community: A Randomized Control Trial

Abstract

Introduction: Cognitive deterioration in older people with mild neurocognitive disorders (mNCD) increases the risk of progress to major NCD. Health professionals worldwide are trying to find strategies for prevention. There is a limited number of studies that deal with cultural conditions in northern Thailand. Objectives: This study aimed to investigate the effects of a combination of physical movement activity and multifaceted cognitive training on cognitive function in older people with mNCD. Methods: A randomized control trial involving 70 mNCD people, according to DSM-5 criteria, was conducted on an intervention group and a control group (n = 35 each). The program for the intervention group included 24 sessions (twice a week). The outcome measures on cognitive function were assessed before and after the intervention by means of composite cognitive measures for older people, i.e., the Trail-Making Test (TMT), Digit Span (DS), Verbal Fluency (VF), Word-List Learning (WLL), and Block Design (BD). Results: The combined intervention enhanced cognitive function. TMT-A was significantly improved in the intervention group. There were significant improvements in DS sequence scores, letter verbal fluency (LVF), and category verbal fluency (CVF). Comparing the groups, there were significant differences in LVF including immediate and delayed recall. BD improved significantly in the intervention group. Conclusions: The combined intervention appeared to be effective in delaying/preventing cognitive deterioration and cognitive functional decline in people with mNCD. Further studies on a variation of treatments suited to cultural conditions and their effects are needed. Trials in other communities are also recommended.

Multimodal cognitive and behavioral interventions for patients with MCI: a systematic review and meta-analysis on cognition and mood

“…Participants’ mean ages were obtained from baseline characteristics for most of the studies except for Griffiths et al (2020) , which only included the number of participants in two age groups (60–69 years) and (70–79 years). Mean ages ranged from 67.82 to 87.20 with a standard deviation of 4.26.…”

“…Verbal fluency measured through semantic and category fluency tests was the domain with the lowest pooled effect size compared to other domains ( g = 0.45, 95% CI = [0.18, 0.73]) ( Figure 6F ). Among the studies that assessed changes in verbal fluency and confrontational naming, two ( Shimada et al, 2018 ; Griffiths et al, 2020 ) reported significant improvements while one noted comparable changes in both groups ( Rojas et al, 2013 ; control: mean change = 2.40, p < 0.01; intervention: mean change = 2.40, p < 0.01). Similar to executive function, lower verbal fluency scores in older adults with MCI could predict progression to AD.…”

“…Most studies included older adults with an MCI diagnosis regardless of subtype. However, four reports included only single or multidomain aMCI ( Buschert et al, 2011 ; Park et al, 2019 ; Jeong et al, 2021 ) and one used the term mNCD and MCI interchangeably ( Griffiths et al, 2020 ). Additionally, this study did not investigate the effects of different modes of delivery (simultaneous vs. sequential).…”

The Effects of Aerobic Exercise in Patients with Early-Onset Dementia: A Scoping Review

“…Besides the beneficial effects on divers cognitive domains, they also indicated that physical activity/exercise significantly decreased risk and number of falls, and that physical activity/exercise may improve depression and behavioral and psychological symptoms in dementia [28]. Finally, some recent randomized controlled trials have shown that a combined exercise and cognitive training improves attention, concentration, cognitive function and activities of daily living in dementia patients [31] and is effective in delaying/preventing cognitive deterioration and cognitive functional decline in people with MCI [32]. Although there is no consensus on the most effective modalities, it is remarkable that exercise (single- or multicomponent) seems to be a constant key factor in this context.…”

Lifestyle interventions for dementia prevention in Low- and Middle-Income Countries: A systematic review

“…With an adherence rate of 82.6%, authors found a significant increase in cognition in the Baduanjin compared to non-exercise group (p = .050). Griffiths et al (2020) tested a physical movement (up to 30 minutes) and cognitive stimulating (up to 90 minutes) activities intervention over 12 weeks, without using of technology and led by three occupational therapists. The intervention found improvements in attention (p = 0.018), memory (immediate, p = 0.001; delayed recall, p = 0.001).…”