The Healthy Mind, Healthy Mobility Trial: A Novel Exercise Program for Older Adults.
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.
1Department 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.
Dawn P
DP
Gill
Michael A
MA
Gregory
Guangyong
G
Zou
Teresa
T
Liu-Ambrose
Ryosuke
R
Shigematsu
Vladimir
V
Hachinski
Clara
C
Fitzgerald
Robert J
RJ
Petrella
D000368:Aged; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000517:prevention & control; D015444:Exercise / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D016037:Single-Blind Method