Effects of Combining Physical and Cognitive Training on Older Adults’ Physical Performance and Functional Abilities: A Systematic Review

Abstract

Background: The combination of physical and cognitive training effectively enhances the physical function of the elderly by preventing and reducing the incidence of falls as well as increasing independence in daily activities. However, the optimal combination of strategies to achieve the best physical performance and functional capacity in healthy elderly is still being explored. Objective: This study aimed to explore effective combinations to improve physical function. Methods: A comprehensive database search was done through Web of Science, Medline, Embase and PubMed, and was supplemented with Google scholar since September 2022. Titles and abstracts were used to search for keywords, and data were extracted using the Participants; Interventions; Comparisons, and Outcomes (PICO). Results: The 23 included studies recruited subjects aged 65 and older, comprising 872 females and 497 males, while some research did not identify the gender of 216 participants. Among the included studies, 16 were of high quality while 7 were of low quality. Ten studies showed a significant improvement in gait among older adults who underwent combined physical-cognitive training, while two studies found no positive effect on dual-task gait performance. All five studies showed a significant improvement in strength. Out of the four studies conducted, only one showed no improvement in endurance. All five studies showed improved mobility, while only one study found no effect on agility. However, eight out of the eleven papers showed a significant improvement in balance for older adults who underwent combined cognitive and physical training. The three papers that effectively reduced the fear of falling were also significant. Two studies showed that those who received combined training exhibited a significantly better quality of life compared to those who did not. Conclusion: Combined motor-cognitive training is an advanced, feasible and effective method that can promote the improvement of gait, balance and overall health in the elderly. This type of training has a more significant impact on the elderly’s fall response compared to general physical or cognitive training. Additionally, it contributes to promoting functional independence.