A Multimodal Intervention to Improve Cognition in Community-dwelling Older Adults

Abstract

To examine the effects of a multimodal intervention composed of cognitive training, physical exercise, and group counseling on cognitive function in community-dwelling older adults. A four-armed, quasi-experimental intervention study. Community-dwelling adults aged 60 years and older (n=153). Participants were allocated into multimodal intervention, cognitive training plus Taichi exercise, cognitive training, or control group. The multimodal intervention included 18 sessions of cognitive training, 18 sessions of Taichi, and 6 sessions of group reminiscence over six weeks. Cognitive function, depressive symptoms, and psychological well-being were assessed at the baseline, postintervention, and three-month follow-up. The primary outcome was the change in overall cognition measured by the Montreal Cognitive Assessment (MoCA) and a composite cognitive score derived from a battery of neuropsychological tests. For MoCA, there was no significant difference between any of the three intervention groups and controls. For composite cognition, all three intervention groups showed improvements at the three-month follow-up, with a large effect size in the cognitive training plus Taichi group (change difference 0.37, 95% CI 0.18-0.56, Hedge's g=0.92), and medium effect sizes in the multimodal intervention group (change difference 0.23, 95% CI 0.0 -0.42, g=0.58) and cognitive training group (change difference 0.22, 95% CI 0.03-0.42, g=0.55). Multimodal intervention, cognitive training plus Taichi, and cognitive training could foster cognitive function in community-dwelling older adults. The combination of cognitive training and Taichi showed greater efficacy than the other two interventions.