Emma Gabrielle Dupuy , Florent Besnier , Christine Gagnon , Thomas Vincent , Tudor Vrinceanu , Caroll-Ann Blanchette , Jeremy Gervais , Juliana Breton , Kathia Saillant , Josep Iglesies-Grau , Sylvie Belleville , Martin Juneau , Paolo Vitali , Anil Nigam , Mathieu Gayda , Louis Bherer
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However, the benefits of remotely monitored intervention combining physical exercise and cognitive training for older adult cognition remain to be demonstrated.</div></div><div><h3>Methods</h3><div>127 older adults (age: 65.20 ± 7.95) were randomized in two arms, encouraging self-engagement in six months of home-based physical exercise alone or combined with cognitive training, monitored by phone once a week. Neuropsychological assessment was performed under videoconference supervision at baseline and after three and six months. Composite <em>Z</em>-scores were calculated for processing speed, executive functioning, working, and episodic memory to assess changes after three and six months of training. The weekly metabolic expenditure of self-reported activities was estimated using the compendium of physical activity to distinguish participants performing higher and lower doses of exercise (median split).</div></div><div><h3>Results</h3><div>106 participants (83.46 %) completed the 6-month training. Results showed a greater <em>Z</em>-score change in executive functioning for participants in the combined arm than those who only exercised (F = 4.127, <em>p</em> = 0.046, η<sub>p</sub><sup>2</sup> = 0.050). Group x Exercise dose interaction was observed for episodic memory Z-score change (F = 6.736, <em>p</em> = 0.011, η<sub>p</sub><sup>2</sup> = 0.070), with a greater improvement for participants performing higher doses of exercise compared to those who performed a lower dose, only in exercise alone arm. Performing a higher dose of exercise increased the working memory <em>Z</em>-score change in both intervention arms compared to a lower dose (F = 7.391, <em>p</em> = 0.008, η <sub>p</sub><sup>2</sup> = 0.076).</div></div><div><h3>Conclusion</h3><div>Remote combined training may lead to larger improvement in executive functioning than exercise alone. Physical exercise showed a dose-related improvement in working and episodic memory performances. The combination of cognitive interventions mitigated the effects of exercise on episodic memory. These results suggest that home-based exercise and cognitive training may help improve older adults' cognition.</div></div><div><h3>Trial registration</h3><div>COVEPIC was retrospectively registered on December 03, 2020. 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引用次数: 0
摘要
背景：有组织、有监督的体育锻炼和认知训练是提高老年人认知能力的两种有效方法。由于这两种方法对大脑功能具有潜在的协同作用，因此在联合干预中进行这两种方法可以最大限度地提高对认知的影响。在 COVID-19 大流行期间，由于社会对体育活动和认知刺激水平的限制所产生的附带影响，这些干预措施尤为重要。方法：将 127 名老年人（年龄：65.20 ± 7.95）随机分为两组，鼓励他们自我参与为期 6 个月的单独或结合认知训练的家庭体育锻炼，每周通过电话监测一次。基线期、三个月和六个月后，在视频会议监督下进行神经心理学评估。计算处理速度、执行功能、工作记忆和片段记忆的综合 Z 值，以评估训练 3 个月和 6 个月后的变化。每周自我报告活动的新陈代谢消耗量是通过体育活动简编进行估算的，以区分进行高剂量和低剂量运动的参与者（中位数分割）：结果：106 名参与者（83.46%）完成了为期 6 个月的训练。结果显示，与只进行锻炼的参与者相比，联合组参与者的执行功能Z-score变化更大（F = 4.127，p = 0.046，ηp2 = 0.050）。在表观记忆 Z 评分变化方面，观察到了组别 x 运动剂量的交互作用（F = 6.736，p = 0.011，ηp2 = 0.070），与进行低剂量运动的参与者相比，进行高剂量运动的参与者的表观记忆 Z 评分变化更大。与低剂量运动相比，高剂量运动增加了两个干预组的工作记忆Z-分数变化（F = 7.391, p = 0.008, η p2 = 0.076）：结论：与单独锻炼相比，远程联合训练可能会对执行功能带来更大的改善。体育锻炼对工作记忆和外显记忆的改善与剂量有关。认知干预措施的结合减轻了运动对外显记忆的影响。这些结果表明，基于家庭的运动和认知训练可能有助于改善老年人的认知能力：COVEPIC于2020年12月3日进行了回顾性注册：NCT04635462 - https://clinicaltrials.gov/ct2/show/record/NCT04635462?term=NCT04635462&draw=2&rank=1.
Effects of home-based exercise alone or combined with cognitive training on cognition in community-dwelling older adults: A randomized clinical trial
Background
Structured and supervised physical exercise and cognitive training are two efficient ways to enhance cognition in older adults. Performing both within a combined intervention could maximize their effect on cognition due to their potential synergy on brain functions. During the COVID-19 pandemic, these interventions were particularly relevant due to the collateral impact of social restrictions regarding physical activity and the level of cognitive stimulation. However, the benefits of remotely monitored intervention combining physical exercise and cognitive training for older adult cognition remain to be demonstrated.
Methods
127 older adults (age: 65.20 ± 7.95) were randomized in two arms, encouraging self-engagement in six months of home-based physical exercise alone or combined with cognitive training, monitored by phone once a week. Neuropsychological assessment was performed under videoconference supervision at baseline and after three and six months. Composite Z-scores were calculated for processing speed, executive functioning, working, and episodic memory to assess changes after three and six months of training. The weekly metabolic expenditure of self-reported activities was estimated using the compendium of physical activity to distinguish participants performing higher and lower doses of exercise (median split).
Results
106 participants (83.46 %) completed the 6-month training. Results showed a greater Z-score change in executive functioning for participants in the combined arm than those who only exercised (F = 4.127, p = 0.046, ηp2 = 0.050). Group x Exercise dose interaction was observed for episodic memory Z-score change (F = 6.736, p = 0.011, ηp2 = 0.070), with a greater improvement for participants performing higher doses of exercise compared to those who performed a lower dose, only in exercise alone arm. Performing a higher dose of exercise increased the working memory Z-score change in both intervention arms compared to a lower dose (F = 7.391, p = 0.008, η p2 = 0.076).
Conclusion
Remote combined training may lead to larger improvement in executive functioning than exercise alone. Physical exercise showed a dose-related improvement in working and episodic memory performances. The combination of cognitive interventions mitigated the effects of exercise on episodic memory. These results suggest that home-based exercise and cognitive training may help improve older adults' cognition.
Trial registration
COVEPIC was retrospectively registered on December 03, 2020. Clinical trials Identifier: NCT04635462 - https://clinicaltrials.gov/ct2/show/record/NCT04635462?term=NCT04635462&draw=2&rank=1
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