MULTIPLE-MODALITY EXERCISE AND MIND-MOTOR TRAINING TO IMPROVE COGNITION IN OLDER ADULTS: RESULTS FROM THE M4 STUDY

Abstract

This 24-week randomized controlled trial with a 28-week no-contact follow-up investigated the effects of multiple-modality exercise with or without the addition of a novel form of mind-motor training (i.e., Square-Stepping Exercise) on cognition in community-dwelling older adults with subjective cognitive complaints. Participants [n=127, 67.5 (7.3) yr, 71% females] were randomized to either the M4 (n=63) or M2 (n=64) groups. Both groups received multiple-modality exercise intervention (i.e., 45 min of aerobic exercise and resistance training); however, the M4 group underwent additional 15 minutes of mind-motor training, whereas the M2 group received 15 minutes of balance, range of motion and breathing exercises. In total, both groups exercised 60 min/day, 3 days/week for 24-weeks. Participants were assessed in global cognitive functioning (GCF), concentration, reasoning, planning and memory using the computer-based Cambridge Brain Sciences (CBS) cognitive battery. Additionally, frequency and duration of recreational physical activities (PA) were collected using the Phone-FITT questionnaire. Assessments were conducted at baseline, intervention endpoint (24-weeks) and study endpoint (52-weeks). There were no statistically significant differences between groups at 24-weeks; however, the M4 group showed a trend to greater improvement in GCF (p=.071) and memory (p=.067). Improvements within groups from baseline were seen at 24-weeks in GCF (M2: p=.001; M4: p<.001), concentration (M2: p=.044; M4: p=.001), reasoning (M2: p=.018; M4: p=.005), planning (M4 only: p=.005) and memory (M4 only: p=.001). At 52-weeks, the M4 group demonstrated greater performance in GCF (p=0.022) and memory (p=.026) compared to the M2 group. Differences within groups from baseline remained significant in GCF (M2: p=.001; M4: p<.001), concentration (both groups: p<.001), reasoning (M2: p=.014; M4: p=.002), planning (M4 only: p<.001), and memory (M4 only: p<.001). Also, the M4 group increased PA at 52-weeks (p=.015) compared to baseline, with no differences between groups. 24 weeks of multiple-modality exercise interventions with or without additional mind-motor training yielded similar improvements in cognition among community-dwelling older adults with subjective cognitive complaints. Although both groups improved GCF and memory during the study intervention and after the no-contact follow-up, the M4 group demonstrated significantly greater improvements in these outcomes at 52-weeks.