Date Presented 04/05/19
Mild cognitive impairment (MCI) is a syndrome defined as an intermediate stage between cognitively intact and clinically diagnosed dementia; the age-adjusted prevalence of MCI in Taiwan is approximately 18%. Combination of cognitive training and exercise has been found to be effective for improving cognitive functions. However, it is still unclear which combination method could induce better training effects. This study provides and discusses emerging work from Taiwan’s experience.
Primary Author and Speaker: Ching-yi Wu
Additional Authors and Speakers: I-Ching Chuang
PURPOSE: Mild Cognitive Impairment (MCI) is a transitional state between normal aging and early dementia. The rate of progression to dementia among persons with MCI was 10-15% per year. Combining physical exercise and cognitive training have positive influences on cognitive function in these people. The distinct training effects may be related to different combination methods. Both the sequential and dual-task trainnings appear to be beneficial for improving cognitive functions in adults with MCI. However, it is still unclear which combination method could induce better training effects. The aim of this study was to examine the sequential effects of hybrid physical exercise with cognitive training compared with simultaneously combined training on cognitive function, physical function, and activities of daily living (ADL) in older adults with MCI.
DESIGN: This was a randomized controlled trial study. The inclusion criteria in this study were: (1) MMSE≥17 and MoCA<26; (2) clinical dementia rating (CDR) = 0.5 or 1; and (3) self- or informant-reported memory or cognitive complaints. Participants were randomly assigned to sequential combination of physical exercise training and cognitive training group and simultaneous combination of cognitive training and physical exercise as dual-task training group. The SEQ group consisted of 16 participants, and the DUAL group consisted of 11 participants.
METHODS: All participants received group training for 90 min/d, 3 d/wk, for a total of 36 training sessions. The SEQ group received multicomponent exercise program that involves balance training, strength training, and upper and lower limb aerobic exercise followed by computerized cognitive-based training. The DUAL group was instructed to perform the multicomoponent exercise program and cognitive tasks simultaneously. The outcome measures involve cognitive functions, physical function and ADL. Cognitive tests included the Montreal Cognitive Assessment (MoCA), the spatial span subtest of Wechsler Memory Scale (WMS), and dual-task tests. Physical function was evaluated by 30-second chair stand test (CST) and the International Physical Activity Questionnaire (IPAQ). The Lawton Instrumental Activities of Daily Living (IADL) and the Quality of Life in Alzheimer's Disease (QOL-AD) was used to evaluate ADL.
RESULTS: There were no significant differences in demographic characteristics among groups. For the within-group comparison, both group showed a significant improvement on cognitive function. In addition, SEQ had a significant improvement in 30 seconds chair stand and Lawton; DUAL showed a significant improvement in quality of life. When comparisons between these two groups were made, a small to moderate effect was found for MoCA (η
2 =0.02), BBT counting (η
2 =0.05), and IPAQ (η
2 =0.06) in favor of the SEQ group. The DUAL group outperformed the SEQ group on QoL with a small effect (η
2 =0.04), and on Lawton IADL with a moderate effect (η
2 =0.12).
CONCLUSION: The results provided preliminary evidence that both groups improved significantly after training in the cognition function. Additionally, the sequential and dual-task training have different benefits on physical, daily function, and quality of life. The SEQ group appears to improve in physical function and daily function; the DUAL group showed a significant improvement in quality of life. Moreover, the SEQ group was more beneficial on cognition function and physical function than DUAL group; the DUAL group had more improvements in daily function and quality of life compared with the SEQ group. Future studies include a large sample of participants are needed to validate our findings and compare more different cognitive functions.
References
Tait, J. L., Duckham, R. L., Milte, C. M., Main, L. C.,Daly, R. M. (2017). Influence of Sequential vs. Simultaneous Dual-Task Exercise Training on Cognitive Function in Older Adults. Front. Aging Neurosci, 9, 1-10. https://doi.org/10.3389/fnagi.2017.00368
Bamidis, P. D., Fissler, P., Papageorgiou, S. G., Zilidou, V., Konstantinidis, E. I., Billis, A. S., … Kolassa, I. T. (2015). Gains in cognition through combined cognitive and physical training: The role of training dosage and severity of neurocognitive disorder. Frontiers in Aging Neuroscience, 7, 1–15. http://doi.org/10.3389/fnagi.2015.00152
