Dementia Care Research and Psychosocial Factors

Area of Science:

• Neuroscience
• Gerontology
• Clinical Psychology

Background:

• Combined Aerobic exercise and Cognitive Training (ACT) may offer synergistic cognitive benefits through distinct mechanisms.
• Previous research on combined physical and cognitive interventions yielded mixed results due to varied components.
• The ACT Trial investigated the efficacy of a 6-month intervention combining cycling and speed of processing (SOP) cognitive training.

Purpose of the Study:

• To test the efficacy of a combined cycling and speed of processing (SOP) cognitive training program.
• To evaluate the effects of ACT on cognition in community-dwelling older adults diagnosed with amnestic mild cognitive impairment (aMCI).
• To compare the effects of ACT against cycling alone, SOP alone, and a control group.

Main Methods:

• A 2x2 factorial design randomized 146 participants into four groups: control, cycling only, SOP only, and ACT (cycling+SOP).
• Cognition, including executive function and episodic memory, was assessed using EXAMINER and BVMT-R at multiple time points up to 18 months.
• Intention-to-treat analyses utilized linear mixed models with multiple imputation.

Main Results:

• All groups exhibited modest cognitive declines over 18 months.
• The ACT group did not show statistically significant improvements in executive function, memory, or global cognition compared to the cycling-only or SOP-only groups.
• Mild-to-moderate adverse events were infrequent and evenly distributed across groups.

Conclusions:

• The 6-month ACT intervention did not demonstrate statistically superior cognitive benefits over its individual components in older adults with aMCI.
• Observed cognitive outcomes trended positively but did not reach statistical significance, potentially due to smaller-than-expected effect sizes.
• Higher participant attrition and reduced intervention dosage, partly attributed to the COVID-19 pandemic, may have impacted the study's findings.