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The quest for synergy between physical exercise and cognitive stimulation via exergaming in people with dementia: a randomized controlled trial.
Alzheimers Res Ther. 2019 01 05; 11(1):3.AR

Abstract

BACKGROUND

Exercise is often proposed as a non-pharmacological intervention to delay cognitive decline in people with dementia, but evidence remains inconclusive. Previous studies suggest that combining physical exercise with cognitive stimulation may be more successful in this respect. Exergaming is a promising intervention in which physical exercise is combined with cognitively challenging tasks in a single session. The aim of this study was to investigate the effect of exergame training and aerobic training on cognitive functioning in older adults with dementia.

METHODS

A three-armed randomized controlled trial (RCT) compared exergame training, aerobic training and an active control intervention consisting of relaxation and flexibility exercises. Individuals with dementia were randomized and individually trained three times a week during 12 weeks. Cognitive functioning was measured at baseline, after the 12-week intervention period and at 24-week follow-up by neuropsychological assessment. The domains of executive function, episodic memory, working memory and psychomotor speed were evaluated. Test scores were converted into standardized z-scores that were averaged per domain. Between-group differences were analysed with analysis of covariance.

RESULTS

Data from 115 people with dementia (mean (SD) age = 79.2 (6.9) years; mean (SD) MMSE score = 22.9 (3.4)) were analysed. There was a significant improvement in psychomotor speed in the aerobic and exergame groups compared to the active control group (mean difference domain score (95% CI) aerobic versus control 0.370 (0.103-0.637), p = 0.007; exergame versus control 0.326 (0.081-0.571), p = 0.009). The effect size was moderate (partial η[2] = 0.102). No significant differences between the intervention and control groups were found for executive functioning, episodic memory and working memory.

CONCLUSIONS

To our knowledge, this is the first RCT evaluating the effects of exergame training and aerobic training on cognitive functioning in people with dementia. We found that both exergame training and aerobic training improve psychomotor speed, compared to an active control group. This finding may be clinically relevant as psychomotor speed is an important predictor for functional decline. No effects were found on executive function, episodic memory and working memory.

TRIAL REGISTRATION

Netherlands Trial Register, NTR5581 . Registered on 7 October 2015.

Authors+Show Affiliations

Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Geriatric Medicine, Nijmegen, the Netherlands. Radboud University Medical Center, Radboudumc Alzheimer Center, Nijmegen, the Netherlands.Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Medical Psychology, Nijmegen, the Netherlands.BeweegStrateeg, Groningen, the Netherlands. Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.Radboud University Medical Center, Department for Health Evidence, Nijmegen, the Netherlands.Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Geriatric Medicine, Nijmegen, the Netherlands. Radboud University Medical Center, Radboudumc Alzheimer Center, Nijmegen, the Netherlands.Radboud University Medical Center, Radboudumc Alzheimer Center, Nijmegen, the Netherlands. Roy.Kessels@Radboudumc.nl. Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Medical Psychology, Nijmegen, the Netherlands. Roy.Kessels@Radboudumc.nl. Center for Cognition, Donders Institute for Brain Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands. Roy.Kessels@Radboudumc.nl.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30611286

Citation

Karssemeijer, Esther G A., et al. "The Quest for Synergy Between Physical Exercise and Cognitive Stimulation Via Exergaming in People With Dementia: a Randomized Controlled Trial." Alzheimer's Research & Therapy, vol. 11, no. 1, 2019, p. 3.
Karssemeijer EGA, Aaronson JA, Bossers WJR, et al. The quest for synergy between physical exercise and cognitive stimulation via exergaming in people with dementia: a randomized controlled trial. Alzheimers Res Ther. 2019;11(1):3.
Karssemeijer, E. G. A., Aaronson, J. A., Bossers, W. J. R., Donders, R., Olde Rikkert, M. G. M., & Kessels, R. P. C. (2019). The quest for synergy between physical exercise and cognitive stimulation via exergaming in people with dementia: a randomized controlled trial. Alzheimer's Research & Therapy, 11(1), 3. https://doi.org/10.1186/s13195-018-0454-z
Karssemeijer EGA, et al. The Quest for Synergy Between Physical Exercise and Cognitive Stimulation Via Exergaming in People With Dementia: a Randomized Controlled Trial. Alzheimers Res Ther. 2019 01 5;11(1):3. PubMed PMID: 30611286.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The quest for synergy between physical exercise and cognitive stimulation via exergaming in people with dementia: a randomized controlled trial. AU - Karssemeijer,Esther G A, AU - Aaronson,Justine A, AU - Bossers,Willem J R, AU - Donders,Rogier, AU - Olde Rikkert,Marcel G M, AU - Kessels,Roy P C, Y1 - 2019/01/05/ PY - 2018/07/13/received PY - 2018/11/27/accepted PY - 2019/1/7/entrez PY - 2019/1/7/pubmed PY - 2020/3/31/medline KW - Alzheimer disease KW - Cognition KW - Cognitive stimulation KW - Dementia KW - Exercise KW - Exergame KW - Neuropsychological KW - Physical activity KW - Randomized controlled trial SP - 3 EP - 3 JF - Alzheimer's research & therapy JO - Alzheimers Res Ther VL - 11 IS - 1 N2 - BACKGROUND: Exercise is often proposed as a non-pharmacological intervention to delay cognitive decline in people with dementia, but evidence remains inconclusive. Previous studies suggest that combining physical exercise with cognitive stimulation may be more successful in this respect. Exergaming is a promising intervention in which physical exercise is combined with cognitively challenging tasks in a single session. The aim of this study was to investigate the effect of exergame training and aerobic training on cognitive functioning in older adults with dementia. METHODS: A three-armed randomized controlled trial (RCT) compared exergame training, aerobic training and an active control intervention consisting of relaxation and flexibility exercises. Individuals with dementia were randomized and individually trained three times a week during 12 weeks. Cognitive functioning was measured at baseline, after the 12-week intervention period and at 24-week follow-up by neuropsychological assessment. The domains of executive function, episodic memory, working memory and psychomotor speed were evaluated. Test scores were converted into standardized z-scores that were averaged per domain. Between-group differences were analysed with analysis of covariance. RESULTS: Data from 115 people with dementia (mean (SD) age = 79.2 (6.9) years; mean (SD) MMSE score = 22.9 (3.4)) were analysed. There was a significant improvement in psychomotor speed in the aerobic and exergame groups compared to the active control group (mean difference domain score (95% CI) aerobic versus control 0.370 (0.103-0.637), p = 0.007; exergame versus control 0.326 (0.081-0.571), p = 0.009). The effect size was moderate (partial η[2] = 0.102). No significant differences between the intervention and control groups were found for executive functioning, episodic memory and working memory. CONCLUSIONS: To our knowledge, this is the first RCT evaluating the effects of exergame training and aerobic training on cognitive functioning in people with dementia. We found that both exergame training and aerobic training improve psychomotor speed, compared to an active control group. This finding may be clinically relevant as psychomotor speed is an important predictor for functional decline. No effects were found on executive function, episodic memory and working memory. TRIAL REGISTRATION: Netherlands Trial Register, NTR5581 . Registered on 7 October 2015. SN - 1758-9193 UR - https://www.unboundmedicine.com/medline/citation/30611286/The_quest_for_synergy_between_physical_exercise_and_cognitive_stimulation_via_exergaming_in_people_with_dementia:_a_randomized_controlled_trial_ DB - PRIME DP - Unbound Medicine ER -