title: Combined Dual-Task Gait Training and Aerobic Exercise to Improve Cognition, Mobility, and Vascular Health in Community-Dwelling Older Adults at Risk for Future Cognitive Decline1.
abstract: This 6-month experimental case series study investigated the effects of a dual-task gait training and aerobic exercise intervention on cognition, mobility, and cardiovascular health in community-dwelling older adults without dementia. Participants exercised 40 min/day, 3 days/week for 26 weeks on a Biodex GaitTrainer2 treadmill. Participants were assessed at baseline (V0), interim (V1: 12-weeks), intervention endpoint (V2: 26-weeks), and study endpoint (V3: 52-weeks). The study outcomes included: cognition [executive function (EF), processing speed, verbal fluency, and memory]; mobility: usual & dual-task gait (speed, step length, and stride time variability); and vascular health: ambulatory blood pressure, carotid arterial compliance, and intima-media thickness (cIMT). Fifty-six participants [age: 70(6) years; 61% female] were included in this study. Significant improvements following the exercise program (V2) were observed in cognition: EF (p = 0.002), processing speed (p < 0.001), verbal fluency [digit symbol coding (p < 0.001), phonemic verbal fluency (p < 0.001)], and memory [immediate recall (p < 0.001) and delayed recall (p < 0.001)]; mobility: usual & dual-task gait speed (p = 0.002 and p < 0.001, respectively) and step length (p = 0.001 and p = 0.003, respectively); and vascular health: cIMT (p = 0.002). No changes were seen in the remaining outcomes. In conclusion, 26 weeks of dual-task gait training and aerobic exercise improved performance on a number of cognitive outcomes, while increasing usual & dual-task gait speed and step length in a sample of older adults without dementia.
authors.affiliation: Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.|Lawson Health Research Institute, London, ON, Canada.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gregory
authors.affiliation: Lawson Health Research Institute, London, ON, Canada.|School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada.
authors.forename: Narlon C
authors.initials: NC
authors.lastname: Boa Sorte Silva
authors.affiliation: Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.|Lawson Health Research Institute, London, ON, Canada.|Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.|School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada.
authors.forename: Dawn P
authors.initials: DP
authors.lastname: Gill
authors.affiliation: Lawson Health Research Institute, London, ON, Canada.|Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.|Department of Kinesiology, University of Windsor, Windsor, ON, Canada.
authors.forename: Cheri L
authors.initials: CL
authors.lastname: McGowan
authors.affiliation: Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.|Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, Canada.
authors.forename: Teresa
authors.initials: T
authors.lastname: Liu-Ambrose
authors.affiliation: School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada.
authors.forename: J Kevin
authors.initials: JK
authors.lastname: Shoemaker
authors.affiliation: Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON, Canada.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Hachinski
authors.affiliation: School of Occupational Therapy, Faculty of Health Sciences, Western University, London, ON, Canada.
authors.forename: Jeff
authors.initials: J
authors.lastname: Holmes
authors.affiliation: Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.|Lawson Health Research Institute, London, ON, Canada.|School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada.|Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Petrella
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D059168:Carotid Intima-Media Thickness; D003072:Cognition Disorders / Q000534:rehabilitation*; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests
keywords: Aging; dual-task exercise; executive function; laboratory-based; prevention