Can dual-task high-velocity exercise training improve cognitive function in older adults? Secondary analysis of an 18-month cluster randomized controlled trial

BackgroundOlder adults experience age-related declines in physical and cognitive functions due to interactions between aging and chronic diseases. Tai Chi and Qigong (TCQ) might be beneficial in improving the physical function and delaying the cognitive decline of this population. The potential underlying mechanism was explored to determine the effects of TCQ on cognitive function via direct or indirect pathways.PurposeThe objective of this systematic review was to determine the effects of TCQ on cognitive and physical functions in older adults using meta-analysis, and to determine the impact of TCQ on cognitive function while controlling for physical function using a meta-regression approach.MethodsA systematic search of 13 electronic databases (in English, Korean, and Chinese languages) identified 10,292 potentially eligible studies published between inception and May 2022. The bias in individual studies was assessed using the Cochrane Risk of Bias (version 2.0) tool. The heterogeneity of the studies was evaluated using a 95% prediction interval, and the meta-analysis and meta-regression were implemented using the Comprehensive Meta-Analysis (version 3) software.ResultsOur search identified 17 randomized studies (n = 2,365, mean age = 70.3 years). The results of the meta-analysis that used a random-effects model indicated that TCQ had significant effects on both cognitive (Hedges' g = 0.29, 95% confidence interval [CI] = 0.17 to 0.42) and physical (Hedges' g = 0.32, 95% CI = 0.19 to 0.44) functions. We used meta-regression to explore the effect size of TCQ in association with physical function level. The regression model was significant (Q = 25.01, p = .070), and 55% of the heterogeneity was explained by physical function as a moderator variable. The effects of TCQ on cognitive function remained significant in this model when controlling for the effect of physical function (β = 0.46, p = .011).ConclusionThis meta-regression of 17 randomized studies strongly suggests that TCQ has beneficial effects on physical and cognitive functions in older adults. The effect of TCQ on cognitive function remained significant after taking into account the significant effects of physical function as a moderator. The findings imply the potential health benefits of TCQ by promoting cognitive function in older adults directly and indirectly through enhancing physical function.PROSPERO registration number*PROSPERO international prospective register of systematic reviews, registration ID CRD42023394358.

Studies suggest that regular physical activity can help maintain and enhance brain functions in older adults. However, we still do not understand how physical activity impacts the rate of cognitive decline. One major issue is whether physical activity broadly defined (i.e., activity that is part of one's daily life involving bodily movements and the use of skeletal muscles) or structured exercise (i.e., physical activity that is planned, structured, and purposive to improve physical fitness) leads to the same benefits in preventing age-related cognitive decline. More studies are needed to appreciate the level of change or protection provided by physical activity, the basic mechanisms by which this change occurs, and whether physical activity can be beneficial despite chronic medical conditions and neurological or geriatric syndromes. This special issue presents original research results that bring additional support to the notion that physical exercise is an efficient nonpharmaceutical approach that can be used to enhance and maintain cognitive functions in healthy older adults and patients suffering from mild cognitive impairment. In a paper, we propose a brief review of the main impacts of exercise on cognition in older adults, frail patients, and those with mild cognitive impairment and dementia. Another paper of this special issue brings important knowledge in this regard. L. S. Nagamatsu et al. showed that physical activity helps improve verbal and spatial memory in older adults with probable mild cognitive impairment. In this study, eighty-six women aged 70–80 years with subjective memory complaints completed one of three interventions for 6 months: resistance training, aerobic training, or balance and tone (control). Both exercise groups showed significant improvements in memory performance, which was not observed in controls. An original study of this special issue explored the benefits of swimming on cognition in older adults. A. Abou-Dest et al. compared three groups of sixteen volunteer participants (young adults, sedentary older adults, and older adults who regularly practice swimming) on a battery of cognitive tasks. They reported that in older adults, regular swimming was related to better performance on executive functions but not on information processing speed. The selective benefit of exercise on executive control tasks was also reported after only 3 months of exercise intervention in a study of this special issue by D. Predovan et al. compared to controls, the training group showed significant improvements in physical capacity and enhanced Stroop performance, but only in the inhibition/switching condition, and the increase in aerobic capacity induced by the training regimen correlated negatively with reaction time in the inhibition/switching condition of the Stroop task at posttest. Importantly, the reported gains in cognitive performance were observed after only three months of physical training. The complex interaction between bodily exercise and cognition also calls into question the impact that mobility and gait might have on cognition in older adults. P. Plummer-D'Amato et al. addressed this issue in a contribution to this special issue. Studying how gait difficulty and cognitive task difficulty impact cognitive-motor interference in aging, they showed that gait task difficulty influences dual-task effects on gait speed, especially in older adults, and that this effect is influenced by the difficulty of the cognitive task. Another paper of the special issue brings up important issues on the potential moderators of physical activity on brain functions. R. L. Leckie et al. demonstrated how genes (APOE, BDNF, and COMT) along with dietary omega-3 fatty acid and docosahexaenoic acid (DHA) are potential moderators of the effect of physical activity on brain health. R. L. Leckie et al.'s proposal calls for further studies on the role of genes and dietary factors in the relationship between physical exercise and cognitive functions in older adults populations. All together, the studies published in this special issue bring additional scientific support to the notion that physical activity and exercise are a promising approach to alleviate the age-related impact on the body and mind. By doing so, they also support the promotion of health policies that should target inactivity in individuals of all ages and with any medical condition who are able to safely participate in physical activity.

There is evidence of a demographic shift in the prevalence of multiple sclerosis (MS) such that it is now common in older adults. Older adults with MS undergo declines in function, and aging with MS may compromise one's perception of confidence for managing this disease and its manifestations. This cross-sectional study examined the associations between self-efficacy and physical and cognitive function in older (≥ 60 years) adults with MS. The sample included 40 older adults with MS who completed the Multiple Sclerosis Self-efficacy (MSSE) Scale, undertook measures of physical and cognitive function, and wore an accelerometer for 7 days. The data were analyzed using partial Spearman correlations and linear regression. Correlation analyses indicated that function, but not control, subscale scores on the MSSE Scale correlated with all measures of physical, but not cognitive, function. Linear regression analyses indicated that the function subscale of the MSSE Scale was the only variable that consistently explained variance in physical function outcomes. The findings are novel evidence of the association between self-efficacy for function and physical function outcomes in older adults with MS. Future research on self-efficacy is warranted with the goal of improving physical function in older adults with MS.

BackgroundWith the increase in life expectancy, age-related cognitive decline has become a prevalent concern. Physical activity (PA) is increasingly being recognized as a vital non-pharmacological strategy to counteract this decline. This review aimed to (i) critically evaluate and synthesize the impact of different PA and exercise modalities (aerobic, resistance, and concurrent training) on cognitive health and overall well-being in older adults, (ii) discuss the influence of exercise intensity on cognitive functions, and (iii) elucidate the potential mechanisms through which PA and exercise may enhance or mitigate cognitive performance among older adults.Main BodyAn exhaustive analysis of peer-reviewed studies pertaining to PA/exercise and cognitive health in older adults from January 1970 to February 2025 was conducted using PubMed, Scopus, Web of Science, PsycINFO, and MEDLINE. There is compelling evidence that aerobic and resistance training (RT) improve cognitive function and mental health in older adults, with benefits influenced by the type and intensity of exercise. Specifically, moderate-intensity aerobic exercise appears to bolster memory, executive functions, and mood regulation, potentially through increased cerebral blood flow, neurogenesis, and production of brain-derived neurotrophic factors in the hippocampus. Moderate-to-high-intensity RT acutely enhances visuospatial processing and executive functions, with chronic training promoting neurogenesis, possibly by stimulating insulin-like growth factor-1 and augmenting blood flow to the prefrontal cortex. Findings related to the effects of concurrent training on cognitive function and mental health are heterogeneous, with some studies reporting no significant impact and others revealing substantial improvements. However, emerging evidence indicates that the combination of concurrent training and cognitive tasks (i.e., dual tasks) is particularly effective, often outperforming aerobic exercise alone.ConclusionsRegular aerobic and RT performance is beneficial for older adults to mitigate cognitive decline and enhance their overall well-being. Specifically, engaging in moderate-intensity aerobic exercises and moderate-to-high-intensity RT is safe and effective in improving cognitive function and mental health in this demographic. These exercises, which can be conveniently incorporated into daily routines, effectively enhance mental agility, memory, executive function, and mood. The findings related to concurrent training are mixed, with emerging evidence indicating the effectiveness of combined concurrent and cognitive tasks on cognitive health and well-being in older adults.Key Points- Moderate-intensity aerobic exercise is associated with significant improvements in cognitive function, mood regulation, and overall well-being in older adults. These benefits are linked to structural and functional changes in the brain such as increased hippocampal volume and elevated levels of brain-derived neurotrophic factor.- Moderate-to-high-intensity resistance training, both in acute and chronic forms, enhances cognitive performance in older adults, particularly in executive functions and visuospatial processing. Cognitive benefits, including improvements in information-processing speed, attention, and memory, can be sustained through regular training.- The effects of concurrent resistance and aerobic training on cognitive function in older adults are mixed. However, combining concurrent training with cognitive tasks (i.e., dual-task training) is particularly effective and often outperforms aerobic exercise alone.- Cognitive and well-being improvements from aerobic and resistance training are mediated by mechanisms such as increased cerebral blood flow and oxygen delivery, enhanced neurogenesis, reduced oxidative stress and inflammation, and positive hormonal changes.- While the optimal exercise dosage for promoting cognitive health in older adults remains undetermined, empirical evidence indicates a positive correlation between increased exercise dosage and cognitive health improvements.

BackgroundThe lifestyle intervention ProMuscle, which combines resistance exercise and an increased protein intake, was effective in improving muscle strength, muscle mass, and physical functioning in older adults. However, due to a growing shortage of health care professionals, the rapidly growing aging population cannot be personally guided in the future. Therefore, Uni2Move, a scalable web-based variant of ProMuscle, was designed to reach larger groups of older adults without putting additional burden on health care professionals.ObjectiveThe current study investigated the effects of a web-based lifestyle intervention on muscle strength, protein intake, and physical functioning in healthy older adults. In addition, we conducted a qualitative study to gather key insights of the participants involved, as little is known about older adults’ perceptions of web-based lifestyle interventions.MethodsA pre-post pilot study was conducted in the Netherlands. In the 24-week intervention, 19 healthy adults aged >55 years were included. They performed resistance training at home twice a week for 24 weeks via web-based workout videos. Videos (45‐60 minutes) were recorded by the fitness trainer and mainly focused on training leg muscles. In addition, older adults were advised on increasing protein intake via two web-based consultations by a dietitian in the first 12 weeks and via an e-learning course in the second 12 weeks. Intervention adherence and acceptance was measured in week 25. The 1 repetition maximum knee extension strength, repeated chair rise test, and protein intake were measured at baseline, week 13, and week 25. Linear mixed models were used to test differences over time. Semistructured interviews were used to gather experiences of participants. Atlas.ti version 22 was used to analyze the interviews.ResultsThe mean age of participants (n=19) at baseline was 69 (SD 7) years. The 1 repetition maximum knee extension strength and repeated chair rise test improved significantly during the 24-week intervention with a mean difference of 7.0 kg (95% CI 4.8-9.3; P<.001) and −1.2 seconds (95% CI −1.7 to −0.6; P<.001), respectively. Total protein intake per day did not change, whereas protein intake during breakfast had increased significantly after 13 weeks with a mean difference of 6.9 g (95% CI 1.1-12.7; P=.01). Qualitative research revealed that advantages of the program included no need to travel and exercising in their own environment. Disadvantages were the lack of physical interaction and no corrections by the trainer.ConclusionsThe results of the web-based exercise and nutrition intervention Uni2Move indicate potential improvements of muscle strength and physical functioning in healthy middle-aged and older adults. Providing such lifestyle interventions on the internet could reach an increased number of older adults, providing the opportunity to contribute to the health and independence of the rapidly growing aging population.

Functional power-based exercise training can improve physical performance in older adults and cognitive training can improve measures of cognition, but their combined effects on cognition and related risk factors (neurological and inflammatory markers) remains uncertain. This 6-month cluster randomised controlled trial evaluated the effectiveness of dual-task functional power training (DT-FPT) on cognition and circulating neurological and inflammatory markers in older adults at increased falls risk, and whether intervention responses varied by apolipoprotein-E (ApoE) and brain derived neurotrophic factor (BDNF) polymorphisms. Three hundred residents aged ≥ 65 years at increased falls risk residing in 22 independent-living retirement communities, were randomised by village, to DT-FPT (n = 156, 11 villages) involving a multi-component power-based training program performed simultaneously with cognitive and/or motor tasks (45–60 min, 2/week), or a usual care control (CON) group (n = 144, 11 villages). Cognition (computerized CogState battery), inflammatory cytokines, BDNF, insulin-like growth factor-1, vascular endothelial growth factor, amyloid β (1–40) and (1–42) were assessed at baseline and 6-months. Overall, 233 (78%) participants completed the intervention and adherence averaged 50.1%. DT-FPT led to a net 0.18–0.20 SD benefit versus CON in psychomotor ability/attention and reaction time/attention (both P < 0.05). There were no significant intervention effects on circulating markers, except for a net 10.5% benefit in amyloid β (1–40) in DT-FPT versus CON (P < 0.05). Responses were not influenced by APOE or BDNF genotype. In conclusion, DT-FPT in older adults at increased falls risk can provide some cognitive benefits, but these were not related to corresponding changes in inflammatory or neurological markers or influenced by genotype. Australian New Zealand Clinical Trials Registry (ACTRN12613001161718). http://www.anzctr.org.au/ This project was funded by a grant from the National Health and Medical Research Council (NHMRC) Project (APP1046267).

Background Physical activity has a positive impact on the ageing process, but little is known about the benefits of sport for older adults. Aim The aim of this study was to review and synthesise the available literature regarding the effect of sport participation on physical and cognitive function in older adults. Methods After searching databases, 2422 studies were screened and a total of 16 studies met the eligibility criteria. Quality assessment was undertaken. Results The selected studies assessed either physical function, cognitive function or both. From the studies that assessed physical function ( n = 13), 9 (70%) reported significant improvements in timed up and go, repeated sit to stand, static balance postural sway or walking performance ( p &lt; 0.05). Of the studies that assessed cognitive function ( n = 5), 5 (100%) reported significant improvements in attention and memory ( p &lt; 0.05). The sport participation significantly improved physical function but not cognitive function. The physical benefits of sport participation could be explained through the quantity and quality of training. Conclusion Sport participation can increase physical function in older adults and should be promoted alongside other modes of physical activity.

To examine the effect of combination exercise program on cognitive function of older adults with mild cognitive impairment (MCI), and identify biomarkers associated with improvement of cognitive functions. Subjects were 42 older adults (ages, 60-80years) with MCI. The subjects were randomly classified to traditional Chinese exercise combined with rhythm training group (TCE + RTG, n = 14), walking group (WG, n = 14), and control group (CG, n = 14), according to their level of MMSE scores. These groups exercised for 60minutes at 1 session, 3 sessions a week for 12weeks. The intervention program was conducted under multitask conditions to stimulate attention and memory, and the control group attended 3 education classes. Measurements were administered before, after the 6-week, and after the 12-week intervention period; Measurements: The Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Symbol Digit Modalities Test (SDMT), Activities of Daily Living Scale (ADL), and the 17-item Hamilton Depression Scale (HAMD-17), along with the brain-derived neurotrophic factor (BDNF). A repeated-measures analysis of variance was used to examine differences among the 3 groups and between the 3 testing times (pre-test vs middle-test vs post-test). (1) The TCE + RTG showed significant improvement in the MMSE, MoCA, SDMT, and ADL scale test results (P < .01) and HAMD-17 scale test results (P < .05). The WG also showed significant improvement in the MMSE, MoCA, and HAMD-17 scale test results (P < .05) and the ADL scale test results (P < .01). While there was no significant change in the CG after the intervention. (2) The TCE + RTG and WG showed positive improvement in peripheral blood BDNF levels, while the CG showed a decrease in these test results. There were significant differences between the TCE + RTG and CG before and after the intervention. The results suggested that a TCE + RT is beneficial for improving memory and maintaining general cognitive function and peripheral blood BDNF levels in older adults with MCI. Peripheral blood BDNF levels may predict improvement of cognitive functions in older adults with MCI. Further studies are required to determine the positive effects of TCE + RT on cognitive function in older adults with MCI. Trial Registration: ChiCTR2200058545, Registered 10 April 2022.

Cognitive decline is age-specific or related to dementia and Alzheimer's disease (AD), which poses great concern to older adults. Exercise contributes to cognitive gains, with aerobic exercise (AE) being the most commonly studied type. However, other types, such as resistance exercise (RE), have received less attention in exercise-cognition research. This narrative review aims to synthesize evidence addressing the effects of RE, including the influence of its various parameters on cognitive function in older adults. It also examines the adaptations of neurotrophic factors, brain structure, and brain function in response to RE and explores the relationship between these adaptive responses and cognitive function. A comprehensive search of PubMed databases was conducted up to Jan 2025, identifying 41 randomized controlled trials for inclusion. RE may effectively improve executive function, memory function, and global cognition in older adults with and without cognitive impairment. However, optimal exercise parameters, such as intensity, frequency, and length, remain to be established. Evidence suggests that RE may elevate peripheral insulin-like growth factor 1 levels, increase gray matter thickness, mitigate hippocampal atrophy, and enhance brain activation, all of which appear to contribute to cognitive improvements. Collectively, these studies advance our understanding of the potential role of RE in promoting cognitive and brain health during aging.

A better understanding of the impact of lifestyle factors on cognitive function in older adults is critical for developing intervention strategies to achieve successful aging. Moreover, older adults who fulfill the World Health Organization criteria for anemia have a significantly higher risk of developing dementia. In the current study, we aimed to assess the buffering effects of lifestyle on cognitive function in older Chinese adults through a nationally representative survey. The sample consisted of 1201 participants (mean age: 82.39 ± 12.08 years, 52.1% female) from the 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. Multiple linear regression analyses were used to explore the relationship between changes in lifestyle factors and the rate of cognitive function changes, as well as the effects of the interaction between lifestyle factors and anemia on cognitive function changes. Increased levels of participation in leisure activities, social activities, and dietary diversity delayed cognitive decline. Persistent anemia accelerated cognitive decline, while frequent participation in leisure activities delayed cognitive decline due to anemia. The increased levels of participation in leisure activities, social activities, and dietary diversity can alleviate the cognitive decline caused by aging itself, and more frequently participation in leisure activities can also alleviate the adverse effects of anemia on cognitive function in older adults.

Objective:Higher education is strongly associated with better cognitive function in older adults. Previous research has also showed that positive psychosocial factors, such as selfefficacy and emotional and instrumental support, are beneficial for late-life cognition. There is prior evidence of a buffering effect of self-efficacy on the relationship between educational disadvantage and poor cognition in older adults, however it is not known if other psychosocial factors modify the schooling-cognition relationship. We hypothesized that higher levels of emotional and instrumental support will diminish the association between lower education and lower cognitive test scores among older adults.Participants and Methods:553 older adults without dementia (42.1% non-Latinx Black, 32.2% non-Latinx White, 25.7% Latinx; 63.2% women; average age 74.4 (SD 4.3)) from the Washington Heights-Inwood Columbia Aging Project. Neuropsychological tests assessed four cognitive domains (language, memory, psychomotor processing speed, and visuospatial function). Self-reported emotional and instrumental support were assessed with measures from NIH Toolbox. Linear regression estimated interactions between education and the two support measures on cognition in models stratified by cognitive domain and racial and ethnic group. Covariates included age, sex/gender, and chronic health conditions (e.g. heart disease, stroke, cancer, etc.).Results:Education was associated with cognition across racial and ethnic groups. For every one year of schooling, the processing speed z-score composite was 0.33 higher among Latinx participants, 0.10 among non-Latinx Black participants, and 0.03 higher among non-Latinx White participants. The education-cognition relationship was generally similar across cognitive domains with larger effects in non-Latinx Black and Latinx participants than in White participants. Low education was associated with slower processing speed among Black participants with low emotional support (B = 0.224, 95% CI [0.014, 0.096]), but there was no association between low education and processing speed among Black older adults with high levels of emotional support (beta for interaction = -.142, 95% CI [-0.061, -0.001]). A similar pattern of results was observed for instrumental support (beta for interaction = -.207, 95% CI [-0.064, 0.010]). There were no interactions between support and education on other cognitive domains or among Latinx and White participants.Conclusions:We found that higher levels of emotional and instrumental support attenuate the detrimental effect of educational disadvantages on processing speed in older Black adults. This may occur via benefits of social capital, which provides access to health resources and knowledge, increased social interaction, an emotional outlet allowing the ability to better cope with stress. Longitudinal analyses are needed to examine temporal patterns of associations. In addition, improving equitable access to high quality schools will improve later-life cognitive outcomes for future generations of older adults. However, for the growing number of Black older adults who will not experience the benefits of structural improvements in the education system, emotional and instrumental support may represent a modifiable psychosocial factor to reduce their disproportionate burden of cognitive morbidity.

To investigate the association between cognitive function and body composition in older adults. We collected data on 2080 older adults (>60 years of age) from the National Health and Nutrition Examination Survey (NHANES) for the years 1999-2000 and 2001-2002. Candidate variables included: demographic data (sex, age, race, education level, marital status, poverty-to-income ratio), alcohol consumption, cardiovascular disease, diabetes, osteoporosis, total bone mineral density, and total fat mass. A logistic regression model was established to analyze the association between cognitive function and body composition in older adults. In addition, stratified logics regression analysis was performed by sex and age. Bone mineral density significantly affects cognitive function in older adults (p<0.01). When examining the data according to sex, this correlation is present for women (p < 0.01). For men, though, it is not significant (p = 0.081). Stratified by age, total bone mineral density was significantly correlated with cognitive function in 60-70 and 70-80 years old people, but not in older adults older than 80 years(for 60-70 years old, p = 0.019; for 70-80 years old, p = 0.022). There was no significant correlation between total bone mineral density and cognitive function (p = 0.575). The decrease of total bone mineral density was significantly correlated with cognitive decline in the older adults, especially among women and older people in the 60 to 80 age group. There was no connection between total fat mass, total percent fat, total lean mass, appendicular lean mass, appendicular lean mass /BMI and cognitive function in the older adults.

With the arrival of an aging society, cognitive health in older adults has become a global focal point. Cross-sectional studies have shown that internet use and physical activity may significantly affect cognitive function in older adults, but their longitudinal relationships and underlying mechanisms have not been fully explored. This study aims to explore the relationship between internet use, physical activity, and cognitive function, and examine the mediating role of physical activity. This study uses two rounds of longitudinal data from the China Health and Retirement Longitudinal Study (2018 and 2020), including a total of 2,383 individuals aged 60 and above. Cross-lagged regression analysis is used to test the bidirectional relationship between internet use and cognitive function, while a semi-longitudinal mediation model is used to examine the mediating role of physical activity. The results indicate that there is a bidirectional relationship between internet use, physical activity levels, and cognitive function. Higher levels of internet use are associated with better cognitive function, and physical activity levels mediate the longitudinal relationship between internet use and cognitive function in older adults. This study reveals the complex relationship between cognitive function, internet use, and physical activity in older adults, and provides new perspectives for interventions aimed at improving cognitive health in older adults. Future research should further explore the dynamic changes between these variables to develop more effective intervention strategies and improve cognitive health and well-being in older adults.

Prior studies link specific sleep parameters to physical functioning in older adults. Recent work suggests the utility of examining sleep health from a multidimensional perspective, enabling consideration of an individual’s experience across multiple different sleep parameters (e.g., quality, duration, timing). We examined the associations of multidimensional sleep health with objective, performance-based measures of physical functioning in older adults. We conducted a secondary analysis of 158 adults (Mage=71.8 years; 51.9% female) who participated in the Midlife in the United States (MIDUS) 2 and MIDUS Refresher studies. We used data from daily diaries, wrist actigraphy, and self-report measures to derive a composite multidimensional sleep health score ranging from 0-6, with higher scores indicating better sleep health. Physical function was assessed using gait speed during a 50-foot timed walk, lower extremity strength as measured by a chair stand test, and grip strength assessed with dynamometers. We used hierarchical regression to examine the associations between sleep health and gait speed, lower extremity strength, and grip strength. Age, sex, race, education, depression symptoms, medical comorbidity, and body mass index were covariates in each model. In adjusted analyses, better multidimensional sleep health was significantly associated with faster gait speed (B=.03, p=.01). Multidimensional sleep health was not significantly associated with lower limb strength (B=-.12, p=.89) or grip strength (B=.45, p=.40). Gait speed is a key indicator of functional capacity as well as morbidity and mortality in older adults. Multidimensional sleep health may be a therapeutic target for improving physical functioning and health in older adults.

Acute hospitalization can have catastrophic consequences for physical function and independence in older adults. The inability to regain function following a hospital stay is a strong predictor of re‐hospitalization and mortality. We have shown that nutritional interventions, exercise, and anabolic steroids independently increase muscle size and function, thus representing promising therapeutic strategies.The goal of this pilot study was to test the feasibility of interventions (placebo supplement (P), nutrition supplement (N, whey protein), progressive in‐home exercise + placebo (E+P), exercise + nutrition (E+N), or single testosterone injection (T)) to improve physical function in older adults following acute hospitalization.Subjects (&gt;65 years) were recruited during hospitalization at UTMB Acute Care for Elders unit. Demographics and short physical performance battery (SPPB) were collected at hospital discharge and 1‐month post discharge.Mean baseline SPPB score was 6.6. At 1‐mo testing, interventions tended to enhance improvement in raw SPPB score (P: 1.3, N: 3.3, E+P: 2.2, E+N: 3.2, T: 2.3) and percent of subjects with a clinically meaningful improvement (蠅1 point) (P: 50%, N: 100%, E+P: 80%, E+N: 80%, T: 88%). Gait speed was low in all groups at baseline (0.60‐ 0.71 m/s). Interventions tended to augment gait speed at 1‐mo (P: 25%, N: 50%, E+P: 45%, E+N: 44%, T: 21%).These preliminary data (n=4‐8), from an ongoing clinical trial, indicate that interventions after acute hospitalization are feasible and can improve physical function in older adults.Dairy Research Institute (1229) and UTMB Claude D. Pepper OAIC (5P30‐ AG024832).