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The Healthy Mind, Healthy Mobility Trial: A Novel Exercise Program for Older Adults
Dawn P Gill1, Michael A Gregory, Guangyong Zou
11Department of Family Medicine, Western University, London, ON, CANADA; 2Aging, Rehabilitation & Geriatric Care Research Centre, Lawson Health Research Institute, London, ON, CANADA; 3Department of Epidemiology & National Alzheimer's Coordinating Center, University of Washington, Seattle, WA; 4School of Health and Rehabilitation Sciences, Western University, London, ON, CANADA; 5Department of Epidemiology & Biostatistics, Western University, London, ON, CANADA; 6Robarts Clinical Trials of Robarts Research Institute, Western University, London, ON, CANADA; 7Department of Physical Therapy, University of British Columbia, Vancouver, BC, CANADA; 8Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, CANADA; 9Faculty of Education, Mie University, JAPAN; 10Department of Clinical Neurological Sciences, Western University, London, ON, CANADA; 11Canadian Centre for Activity and Aging, Faculty of Health Sciences, Western University, London, ON, CANADA; and 12School of Kinesiology, Western University, London, ON, CANADA.
Background:
More evidence is needed to conclude that a specific program of exercise and/or cognitive training warrants prescription for the prevention of cognitive decline. We examined the effect of a group-based standard exercise program for older adults, with and without dual-task training, on cognitive function in older adults without dementia.
Methods:
We conducted a proof-of-concept, single-blinded, 26-wk randomized controlled trial whereby participants recruited from preexisting exercise classes at the Canadian Centre for Activity and Aging in London, Ontario, were randomized to the intervention group (exercise + dual-task [EDT]) or the control group (exercise only [EO]). Each week (2 or 3 d · wk(-1)), both groups accumulated a minimum of 50 min of aerobic exercise (target 75 min) from standard group classes and completed 45 min of beginner-level square-stepping exercise. The EDT group was also required to answer cognitively challenging questions while doing beginner-level square-stepping exercise (i.e., dual-task training). The effect of interventions on standardized global cognitive function (GCF) scores at 26 wk was compared between the groups using the linear mixed effects model approach.
Results:
Participants (n = 44; 68% female; mean [SD] age: 73.5 [7.2] yr) had on average, objective evidence of cognitive impairment (Montreal Cognitive Assessment scores, mean [SD]: 24.9 [1.9]) but not dementia (Mini-Mental State Examination scores, mean [SD]: 28.8 [1.2]). After 26 wk, the EDT group showed greater improvement in GCF scores compared with the EO group (difference between groups in mean change [95% CI]: 0.20 SD [0.01-0.39], P = 0.04).
Conclusions:
A 26-wk group-based exercise program combined with dual-task training improved GCF in community-dwelling older adults without dementia.
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