The differential effect of strength, cognitive and aerobic training combinations on cognitive performance and functional abilities in elderly with cognitive decline: The Fit4Alz project.
Ana Filipa Silva, Gilmara Assis, Rui Miguel Silva, Eugenia Murawska-Ciałowicz, Grzegorz Zurek, José Carvalho, Mafalda Sofia Roriz, José Alberto Azevedo, António Sampaio, Telmo Bento, Olivera Jovanovic, Marko Adamovic, Spartaco Grieco, Roberta Germini, Filipe Manuel Clemente
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Abstract
Background: Despite the global impact of neurodegenerative diseases and ongoing research efforts, pharmacological therapies have shown limited benefits. In contrast, physical exercise, with no side effects, has emerged as a non-pharmacological alternative that can enhance brain structure and function, promoting a healthier neurological phenotype.
Objectives: This study aimed to explore the effects of aerobic and strength training methods, both with and without cognitive training, on mitigating or reversing cognitive decline in older adults.
Design, setting, participants: In a randomized controlled trial, a total of 350 participants (average age 72.9 ± 6.0 years, 79 % female), with signs of decline (MoCA score below 26), were assigned to one of five groups: i) strength plus cognitive training (STCT, n = 92); ii) strength training (ST, n = 41); iii) aerobic training (AT, n = 97); iv) aerobic plus cognitive training (ATCT, n = 91); v) control (CG, n = 29).
Intervention: For 12 weeks, all groups followed a 60 min training session three times a week, tailored to their specific group, with half of the sample adding 20 min of cognitive stimulation after the physical exercise.
Measurements: Cognitive and physical assessments were conducted at the start and end of the intervention using the MoCA and the Senior Fitness test. A mixed ANCOVA analysis revealed significant interactions between time and group for all tests.
Results: After the intervention, the CG showed significantly lower scores compared to all experimental groups. The CG also performed significantly worse than the ATCT group (p < 0.001). Additionally, the ATCT outperformed the STCT in the 6-min walk test (p < 0.05), while the STCT showed superior performance in the flexibility tests (sit and reach, back scratch) compared to the CG (p < 0.05).
Conclusions: Results showed that 12-weeks of aerobic and strength training, with or without cognitive components, improved cognitive performance in older adults with cognitive decline, highlighting the importance of maintaining functional abilities for preserving skills, autonomy, independence, and quality of life in aging.
背景：尽管神经退行性疾病的全球影响和正在进行的研究努力，药物治疗已显示出有限的好处。相比之下，没有副作用的体育锻炼已经成为一种非药物替代方法，可以增强大脑结构和功能，促进更健康的神经表型。目的：本研究旨在探讨有氧和力量训练方法，在有或没有认知训练的情况下，对减轻或逆转老年人认知能力下降的影响。设计，环境，参与者：在一项随机对照试验中，共有350名参与者（平均年龄72.9±6.0岁，79%为女性），有下降迹象（MoCA评分低于26），被分配到五组之一：i)力量加认知训练（STCT, n = 92）；ii)力量训练（ST, n = 41）；iii)有氧训练（AT, n = 97）；iv)有氧加认知训练（ATCT, n = 91）；v)控制（CG, n = 29）。干预：在12周的时间里，所有小组都按照他们的特定小组每周三次进行一次60分钟的训练，其中一半的样本在体育锻炼后增加了20分钟的认知刺激。测量方法：在干预开始和结束时使用MoCA和高级体能测试进行认知和身体评估。混合ANCOVA分析显示，所有测试的时间和组之间存在显著的相互作用。结果：干预后，CG评分明显低于各实验组。CG组的表现也明显差于ATCT组（p < 0.001）。此外，ATCT在6分钟步行测试中表现优于STCT (p < 0.05)，而STCT在柔韧性测试（坐下和伸展，背部划伤）中表现优于CG （p < 0.05）。结论：结果显示，12周的有氧和力量训练，无论有无认知成分，都能改善认知能力下降的老年人的认知表现，强调了维持功能能力对于保持技能、自主性、独立性和老年生活质量的重要性。
期刊介绍：
The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.
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