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Effects of simultaneous cognitive and aerobic exercise training on dual-task walking performance in healthy older adults: results from a pilot randomized controlled trial.
BMC Geriatr. 2020 Mar 02; 20(1):83.BG

Abstract

BACKGROUND

The ability to walk and perform cognitive tasks simultaneously is a key aspect of daily life. Performance declines in these dual-tasks may be associated with early signs of neurodegenerative disease and increased risk of falls. Thus, interventions to improve dual-task walking performance are of great interest for promoting healthy aging. Here, we present results of a pilot randomized controlled trial (RCT) to evaluate the effects of a simultaneous aerobic exercise and cognitive training intervention on dual-task walking performance in healthy older adults.

METHODS

Community-dwelling, healthy older adults were recruited to participate in a 12-week RCT. Participants were randomized into one of four groups (n = 74): 1) cognitive training (COG), 2) aerobic exercise (EX), 3) combined aerobic exercise and cognitive training (EXCOG), and 4) video-watching control (CON). The COG and EXCOG groups both used a tablet-based cognitive training program that challenged aspects of executive cognitive function, memory, and processing speed. Performance on a dual-task walking test (DTWT; serial subtraction during two-minute walk) was assessed by researchers blinded to groupings before the intervention, and at 6 and 12 weeks. We included all participants randomized with baseline measurements in an intention to treat analysis using linear mixed effects models.

RESULTS

We found a significant group by time interaction for cognitive performance on the DTWT (p = 0.039). Specifically, participants in the EXCOG, EX, and COG groups significantly improved on the cognitive aspect of the DTWT following the full 12-week intervention (p = 3.5e-7, p = 0.048, p = 0.048, respectively). The improvements in EXCOG were twice as large as in the other groups, and were significant at 6 weeks (p = 0.019). The CON group did not show a significant change in cognitive performance on the DTWT, and no group significantly altered dual-task gait measures following the intervention.

CONCLUSIONS

A simultaneous aerobic exercise and cognitive training intervention significantly improved cognitive performance during a DTWT in healthy older adults. Despite no change in DTWT gait measures, significant improvements in cognitive performance indicate that further investigation in a larger RCT is warranted.

TRIAL REGISTRATION

Clinicaltrials.gov, NCT04120792, Retrospectively Registered 08 October 2019.

Links

Authors+Show Affiliations

Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, 3616 Trousdale Parkway, Los Angeles, CA, 90089-0372, USA. draichle@usc.edu.

Department of Psychology, University of Arizona, 1503 E. University, Tucson, AZ, 85721, USA. Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA.

Department of Psychology, University of Arizona, 1503 E. University, Tucson, AZ, 85721, USA. Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA.

Department of Psychology, University of Arizona, 1503 E. University, Tucson, AZ, 85721, USA. Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA.

Department of Psychology, University of Arizona, 1503 E. University, Tucson, AZ, 85721, USA. Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA.

Department of Psychology, University of Arizona, 1503 E. University, Tucson, AZ, 85721, USA. Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA.

Department of Psychology, University of Arizona, 1503 E. University, Tucson, AZ, 85721, USA. gene.alexander@arizona.edu. Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA. gene.alexander@arizona.edu. Department of Psychiatry, University of Arizona, Tucson, AZ, USA. gene.alexander@arizona.edu. Neuroscience Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA. gene.alexander@arizona.edu. Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA. gene.alexander@arizona.edu. BIO5 Institute, University of Arizona, Tucson, AZ, USA. gene.alexander@arizona.edu. Arizona Alzheimer's Consortium, Phoenix, AZ, USA. gene.alexander@arizona.edu.

MeSH

AgedCognitionExerciseExercise TherapyFemaleHealthy VolunteersHumansMiddle AgedNeurodegenerative DiseasesPilot ProjectsPsychomotor PerformanceTreatment OutcomeWalking

Pub Type(s)

Journal Article

Randomized Controlled Trial

Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32122325

Clinical Trial Links

Clinical trial which this article describes

Citation

Raichlen, David A., et al. "Effects of Simultaneous Cognitive and Aerobic Exercise Training On Dual-task Walking Performance in Healthy Older Adults: Results From a Pilot Randomized Controlled Trial." BMC Geriatrics, vol. 20, no. 1, 2020, p. 83.

Raichlen DA, Bharadwaj PK, Nguyen LA, et al. Effects of simultaneous cognitive and aerobic exercise training on dual-task walking performance in healthy older adults: results from a pilot randomized controlled trial. BMC Geriatr. 2020;20(1):83.

Raichlen, D. A., Bharadwaj, P. K., Nguyen, L. A., Franchetti, M. K., Zigman, E. K., Solorio, A. R., & Alexander, G. E. (2020). Effects of simultaneous cognitive and aerobic exercise training on dual-task walking performance in healthy older adults: results from a pilot randomized controlled trial. BMC Geriatrics, 20(1), 83. https://doi.org/10.1186/s12877-020-1484-5

Raichlen DA, et al. Effects of Simultaneous Cognitive and Aerobic Exercise Training On Dual-task Walking Performance in Healthy Older Adults: Results From a Pilot Randomized Controlled Trial. BMC Geriatr. 2020 Mar 2;20(1):83. PubMed PMID: 32122325.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Effects of simultaneous cognitive and aerobic exercise training on dual-task walking performance in healthy older adults: results from a pilot randomized controlled trial. AU - Raichlen,David A, AU - Bharadwaj,Pradyumna K, AU - Nguyen,Lauren A, AU - Franchetti,Mary Kathryn, AU - Zigman,Erika K, AU - Solorio,Abigail R, AU - Alexander,Gene E, Y1 - 2020/03/02/ PY - 2019/10/18/received PY - 2020/2/20/accepted PY - 2020/3/4/entrez PY - 2020/3/4/pubmed PY - 2020/11/13/medline KW - Aging KW - Cognition KW - Executive function KW - Exergame KW - Physical activity SP - 83 EP - 83 JF - BMC geriatrics JO - BMC Geriatr VL - 20 IS - 1 N2 - BACKGROUND: The ability to walk and perform cognitive tasks simultaneously is a key aspect of daily life. Performance declines in these dual-tasks may be associated with early signs of neurodegenerative disease and increased risk of falls. Thus, interventions to improve dual-task walking performance are of great interest for promoting healthy aging. Here, we present results of a pilot randomized controlled trial (RCT) to evaluate the effects of a simultaneous aerobic exercise and cognitive training intervention on dual-task walking performance in healthy older adults. METHODS: Community-dwelling, healthy older adults were recruited to participate in a 12-week RCT. Participants were randomized into one of four groups (n = 74): 1) cognitive training (COG), 2) aerobic exercise (EX), 3) combined aerobic exercise and cognitive training (EXCOG), and 4) video-watching control (CON). The COG and EXCOG groups both used a tablet-based cognitive training program that challenged aspects of executive cognitive function, memory, and processing speed. Performance on a dual-task walking test (DTWT; serial subtraction during two-minute walk) was assessed by researchers blinded to groupings before the intervention, and at 6 and 12 weeks. We included all participants randomized with baseline measurements in an intention to treat analysis using linear mixed effects models. RESULTS: We found a significant group by time interaction for cognitive performance on the DTWT (p = 0.039). Specifically, participants in the EXCOG, EX, and COG groups significantly improved on the cognitive aspect of the DTWT following the full 12-week intervention (p = 3.5e-7, p = 0.048, p = 0.048, respectively). The improvements in EXCOG were twice as large as in the other groups, and were significant at 6 weeks (p = 0.019). The CON group did not show a significant change in cognitive performance on the DTWT, and no group significantly altered dual-task gait measures following the intervention. CONCLUSIONS: A simultaneous aerobic exercise and cognitive training intervention significantly improved cognitive performance during a DTWT in healthy older adults. Despite no change in DTWT gait measures, significant improvements in cognitive performance indicate that further investigation in a larger RCT is warranted. TRIAL REGISTRATION: Clinicaltrials.gov, NCT04120792, Retrospectively Registered 08 October 2019. SN - 1471-2318 UR - https://www.unboundmedicine.com/medline/citation/32122325/Effects_of_simultaneous_cognitive_and_aerobic_exercise_training_on_dual_task_walking_performance_in_healthy_older_adults:_results_from_a_pilot_randomized_controlled_trial_ DB - PRIME DP - Unbound Medicine ER -