scholarly journals Effects of Physical-Cognitive Dual Task Training on Executive Function and Gait Performance in Older Adults: A Randomized Controlled Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
S. Falbo ◽  
G. Condello ◽  
L. Capranica ◽  
R. Forte ◽  
C. Pesce

Physical and cognitive training seem to counteract age-related decline in physical and mental function. Recently, the possibility of integrating cognitive demands into physical training has attracted attention. The purpose of this study was to evaluate the effects of twelve weeks of designed physical-cognitive training on executive cognitive function and gait performance in older adults. Thirty-six healthy, active individuals aged 72.30 ± 5.84 years were assigned to two types of physical training with major focus on physical single task (ST) training (n=16) and physical-cognitive dual task (DT) training (n=20), respectively. They were tested before and after the intervention for executive function (inhibition, working memory) through Random Number Generation and for gait (walking with/without negotiating hurdles) under both single and dual task (ST, DT) conditions. Gait performance improved in both groups, while inhibitory performance decreased after exercise training with ST focus but tended to increase after training with physical-cognitive DT focus. Changes in inhibition performance were correlated with changes in DT walking performance with group differences as a function of motor task complexity (with/without hurdling). The study supports the effectiveness of group exercise classes for older individuals to improve gait performance, with physical-cognitive DT training selectively counteracting the age-related decline in a core executive function essential for daily living.

Author(s):  
Meggan Porteous ◽  
Sheida Rabipour ◽  
Patrick Davidson

Studies have shown that cognitive functions decline with increasing age. As the population of older adults (OA) has grown, interest in cognitive training programs (CTP) has steadily expanded. The present study investigated whether CTP can lead to improvements in the performance of OA on cognitive tasks. Thirty-five adults (OA; 60-87 years) were recruited to complete 25 sessions of a CTP over five weeks, with assessments completed before and after the program. Thirty-two young adults (YA; 17-27 years) were also recruited to complete one assessment for baseline comparison with OA. During assessments, participants were evaluated using tasks of executive function, including the N-back task of working memory and Flanker task of inhibition. The response time (RT) and hit rates of YA and OA on these tasks were examined at baseline, as well as changes in OA pre- and post-training. Repeated measures analysis of variance indicated a reduction of pre- and post-training RT for the Flanker task. There was no post-training change in RT on the N-back task. While OA hit rates did not change significantly pre- and post-assessment on the Flanker task, they showed increased hit rates post-training in the N-back task. In both tasks, OA and YA hit rates and RT were significantly different, with YA demonstrating lower RT and hit rate compared to OA. Follow-up studies will determine whether other factors can also lead to improvement. Determining whether CTP can improve cognitive performance in OA can help determine the potential of such approaches to prevent or rehabilitate age-related cognitive decline.


2021 ◽  
Vol 13 ◽  
Author(s):  
Ying-Yi Liao ◽  
Mu-N Liu ◽  
Han-Cheng Wang ◽  
Vincent Walsh ◽  
Chi Ieong Lau

Introduction: Engaging in a secondary task while walking increases motor-cognitive interference and exacerbates fall risk in older adults with mild cognitive impairment (MCI). Previous studies have demonstrated that Tai Chi (TC) may improve cognitive function and dual-task gait performance. Intriguingly, with emerging studies also indicating the potential of transcranial direct current stimulation (tDCS) in enhancing such motor-cognitive performance, whether combining tDCS with TC might be superior to TC alone is still unclear. The purpose of this study was to investigate the effects of combining tDCS with TC on dual-task gait in patients with MCI.Materials and Methods: Twenty patients with MCI were randomly assigned to receive either anodal or sham tDCS, both combined with TC, for 36 sessions over 12 weeks. Subjects received 40 min of TC training in each session. During the first 20 min, they simultaneously received either anodal or sham tDCS over the left dorsolateral prefrontal cortex. Outcome measures included dual-task gait performance and other cognitive functions.Results: There were significant interaction effects between groups on the cognitive dual task walking. Compared to sham, the anodal tDCS group demonstrated a greater improvement on cadence and dual task cost of speed.Conclusion: Combining tDCS with TC may offer additional benefits over TC alone in enhancing dual-task gait performance in patients with MCI.Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [TCTR20201201007].


PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258559
Author(s):  
Tiina Savikangas ◽  
Timo Törmäkangas ◽  
Anna Tirkkonen ◽  
Markku Alen ◽  
Roger A. Fielding ◽  
...  

Background Executive functions underlie self-regulation and are thus important for physical activity and adaptation to new situations. The aim was to investigate, if yearlong physical and cognitive training (PTCT) had greater effects on physical activity among older adults than physical training (PT) alone, and if executive functions predicted physical activity at baseline, after six (6m) and twelve months (12m) of the interventions, one-year post-intervention follow-up and an extended follow-up during COVID-19 lockdown. Methods Data from a single-blinded, parallel-group randomized controlled trial (PASSWORD-study, ISRCTN52388040) were utilized. Participants were 70–85 years old community-dwelling men and women from Jyväskylä, Finland. PT (n = 159) included supervised resistance, walking and balance training, home-exercises and self-administered moderate activity. PTCT (n = 155) included PT and cognitive training targeting executive functions on a computer program. Physical activity was assessed with a one-item, seven-scale question. Executive functions were assessed with color-word Stroop, Trail Making Test (TMT) B-A and Letter Fluency. Changes in physical activity were modeled with multinomial logistic models and the impact of executive functions on physical activity with latent change score models. Results No significant group-by-time interaction was observed for physical activity (p>0.1). The subjects were likely to select an activity category higher than baseline throughout the study (pooled data: B = 0.720–1.614, p<0.001–0.046). Higher baseline Stroop predicted higher physical activity through all subsequent time-points (pooled data: B = 0.011–0.013, p = 0.015–0.030). Higher baseline TMT B–A predicted higher physical activity at 6m (pooled data: B = 0.007, p = 0.006) and during COVID-19 (B = 0.005, p = 0.030). In the PT group, higher baseline Letter Fluency predicted higher physical activity at 12m (B = -0.028, p = 0.030) and follow-up (B = -0.042, p = 0.002). Conclusions Cognitive training did not have additive effects over physical training alone on physical activity, but multicomponent training and higher executive function at baseline may support adaptation to and maintenance of a physically active lifestyle among older adults.


Author(s):  
P. Srisuwan ◽  
D. Nakawiro ◽  
S. Chansirikarnjana ◽  
O. Kuha ◽  
P. Chaikongthong ◽  
...  

ACKGROUND: Cognitive interventions have the potential to enhance cognition among healthy older adults. However, little attention has been paid to the effect of cognitive training (CT) on mood and activities of daily living (ADL). OBJECTIVES: To assess the effectiveness of a multicomponent CT using a training program of executive functions, attention, memory and visuospatial functions (TEAM-V Program) on cognition, mood and instrumental ADL. DESIGN: A randomized, single-blinded, treatment-as-usual controlled trial. SETTING: Geriatric clinic in Bangkok, Thailand. PARTICIPANTS: 77 nondemented community-dwelling older adults (mean age 65.7±4.3 years). INTERVENTION: The CT (TEAM-V) program or the treatment-as-usual controlled group. The TEAM-V intervention was conducted over 5 sessions, with a 2-week interval between each session. Of 77 participants randomized (n=40 the TEAM-V program; n=37 the control group). MEASUREMENTS: The Thai version of Montreal Cognitive Assessment (MoCA), The Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-cog), Thai version of Hospital Anxiety and Depression Scale (HADS) and The Chula ADL were used to assess at baseline, 6 months and 1 year. RESULTS: Compared with the control arm, the TEAM-V Program was associated with reducing anxiety (P = 0.004). Compared with the baseline, participants receiving the TEAM-V Program were associated with significantly improved general cognition (MoCA, P < 0.001), immediate recall (word recall task, P = 0.01), retrieval and retention of memory process (word recognition task, P = 0.01), attention (number cancellation part A, P < 0.001) and executive function (maze test, P = 0.02) at 1 year. No training effects on depression (P = 0.097) and IADL (P = 0.27) were detected. CONCLUSIONS: The TEAM-V Program was effective in reducing anxiety. Even though, the program did not significantly improve cognition, depression and ADL compared with the control group, global cognition, memory, attention and executive function improved in the intervention group compared with baseline. Further studies incorporating a larger sample size, longitudinal follow-up and higher-intensity CT should be conducted.


Author(s):  
Katri M Turunen ◽  
Anna Tirkkonen ◽  
Tiina Savikangas ◽  
Tuomo Hänninen ◽  
Markku Alen ◽  
...  

Abstract Background The aim of this study is to investigate whether combined cognitive and physical training provides additional benefits to fall prevention when compared with physical training alone in older adults. Methods This is a prespecified secondary analysis of a single-blind, randomized controlled trial involving community-dwelling men and women aged 70 to 85 years who did not meet the physical activity guidelines. The participants were randomized into combined physical and cognitive training (PTCT, n=155) and physical training (PT, n=159) groups. PT included supervised and home-based physical exercises following the physical activity recommendations. PTCT included PT and computer-based cognitive training. The outcome was the rate of falls over the 12-month intervention (PTCT, n=151 and PT, n=155) and 12-month postintervention follow-up (PTCT, n=143 and PT, n=148). Falls were ascertained from monthly diaries. Exploratory outcomes included the rate of injurious falls, faller/recurrent faller/fall-related fracture status, and concern about falling. Results Estimated incidence rates of falls per person-year were 0.8 (95% CI 0.7–1.1) in the PTCT and 1.1 (95% CI 0.9–1.3) in the PT during the intervention and 0.8 (95% CI 0.7–1.0) versus 1.0 (95% CI 0.8–1.1), respectively, during the postintervention follow-up. There was no significant difference in the rate of falls during the intervention (incidence rate ratio [IRR] 0.78; 95% CI 0.56–1.10, p=0.152) or in the follow-up (IRR=0.83; 95% CI 0.59–1.15, p=0.263). No significant between-group differences were observed in any exploratory outcomes. Conclusion A yearlong PTCT intervention did not result in a significantly lower rate of falls or concern about falling than PT alone in older community-dwelling adults.


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