Cognitive training with and without additional physical activity in healthy older adults: cognitive effects, neurobiological mechanisms, and prediction of training success.

Julia Rahe,Elke Kalbe,Brunhilde Wirth,Andreas Rahn,Gereon R Fink,Juraj Kukolja,Florian Szabados,Josef Kessler,Jutta Becker,Jan B Rosen

doi:10.3389/fnagi.2015.00187

Abstract

Data is inconsistent concerning the question whether cognitive-physical training (CPT) yields stronger cognitive gains than cognitive training (CT). Effects of additional counseling, neurobiological mechanisms, and predictors have scarcely been studied. Healthy older adults were trained with CT (n = 20), CPT (n = 25), or CPT with counseling (CPT+C; n = 23). Cognition, physical fitness, BDNF, IGF-1, and VEGF were assessed at pre- and post-test. No interaction effects were found except for one effect showing that CPT+C led to stronger gains in verbal fluency than CPT (p = 0.03). However, this superiority could not be assigned to additional physical training gains. Low baseline cognitive performance and BDNF, not carrying apoE4, gains in physical fitness and the moderation of gains in physical fitness × gains in BDNF predicted training success. Although all types of interventions seem successful to enhance cognition, our data do not support the hypotheses that CPT shows superior CT gains compared to CT or that CPT+C adds merit to CPT. However, as CPT leads to additional gains in physical fitness which in turn is known to have positive impact on cognition in the long-term, CPT seems more beneficial. Training success can partly be predicted by neuropsychological, neurobiological, and genetic parameters. Unique Identifier: WHO ICTRP (http://www.who.int/ictrp); ID: DRKS00005194.

Highlights

Combined interventions that target at multiple factors, e.g., the combination of cognitive training (CT) with physical activity (CPT), have recently been suggested to be most effective in maintaining or even improving cognitive health (Bamidis et al, 2014; Law et al, 2014)
Given the results of the prediction in performance of alternating letter verbal fluency, we considered the interaction of change in physical fitness × change in brain-derived neurotropic factor (BDNF) on alternating letter verbal fluency and modeled changes in alternating letter verbal fluency a second time based on the predictors apoE4 carrier, baseline performance in (i) alternating letter verbal fluency, (ii) physical fitness, change in (i) BDNF, (ii) physical fitness, and the interaction change in physical fitness × change in BDNF
The main findings of our study are that (i) both cognitive-physical training (CPT) and CT lead to significant cognitive improvements and an increase of peripheral BDNF from pre- to post-test, no significant interaction effect which could support hypothesis 1— that CPT is superior to CT—could be found

Summary

Introduction

Combined interventions that target at multiple factors, e.g., the combination of cognitive training (CT) with physical activity (CPT), have recently been suggested to be most effective in maintaining or even improving cognitive health (Bamidis et al, 2014; Law et al, 2014). Recent randomized controlled trials (RCT) failed to observe superior effects of CPT (Legault et al, 2011; Barnes et al, 2013; Shatil, 2013; Linde and Alfermann, 2014). A recent controlled trial with follow-up assessment indicated that the motivation to remain physically active after the training itself seems to mainly drive superior effects of CPT vs CT (Rahe et al, 2015b). CPT involving motivational physical activity counseling has not been studied yet

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