Increasing daily step count in mild cognitive impairment: a 12-month randomised controlled trial

Despite numerous studies confirming the beneficial effects of physical activity on cognitive function, there is a lack of randomised controlled trials involving long-term, continuous monitoring of physical activity that assess the effect of step-based intervention on cognition-related outcomes. Therefore, this study evaluated whether increasing daily step count improves cognitive performance and brain health markers in individuals with mild cognitive impairment (MCI).

Caucasian, community-dwelling participants aged 50-70 years with MCI and smartphone ownership were recruited for this randomised, controlled, parallel-group study, and assigned to intervention or control groups. The intervention group aimed to achieve ≥10,000 steps daily, with no individualised or baseline-adjusted activity targets, whereas controls maintained usual activity. Physical activity was monitored by wrist-worn trackers over 12 months. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA) and the Cambridge Neuropsychological Test Automated Battery. Brain volume, cardiometabolic, and neurodegeneration biomarkers were assessed.

198 participants were recruited between July 2021 and September 2022 and assigned to the intervention (n = 98) or control (n = 100) group. 188 participants completed the study. Significant differences between groups were found in daily step count (median difference [95% confidence interval]: 1,728 (1,207-2,271), p < 0.0001), the MoCA (1 [0-2], p = 0.0043), spatial working memory errors in the six-box condition (-1 [-2-0], p = 0.0049), waist (-1 [-3-0] cm, p = 0.025), and hip circumferences (-1 [-2-0] cm, p = 0.047). No differences were observed in body composition, biochemical parameters, or brain volume parameters.

In adults with MCI and moderate baseline activity, a small increase in daily step count over 12 months led to modest changes in MoCA scores, while evidence from the broader cognitive battery was limited and largely exploratory. No effect on brain volume, peripheral neurodegeneration markers, body composition, or metabolism was noted (Trial registry: https://drks.de; identifier: DRKS00020943).