Sierra Pacific Mental Illness Research, Education, and Clinical Center at VA Palo Alto Health Care System, Palo Alto, California, USA.
Department of Psychology, Palo Alto University, Palo Alto, California, USA.
J Gerontol A Biol Sci Med Sci. 2023 Mar 1;78(3):554-560. doi: 10.1093/gerona/glac189.
The diagnosis of mild cognitive impairment (MCI) presents a critical period for intervention. Although exercise and cognitive training (CT) interventions have reported independent success in improving cognition, some meta-analyses have suggested that combined interventions provide maximal benefits. Much previous research has studied land-based as opposed to water-based exercise, which places potential barriers on older adults. The purpose of the current study was to examine the impact of combined exercise (water- or land-based) and CT treatment on cognition for older adults with MCI.
Participants were 67 adults ages 54-86 years classified with MCI who engaged in 6 months of land or aquatic-based exercise with subsequent CT over 4 weeks. Primary outcome variables were performance measures of several cognitive domains across 3-time points (baseline, following exercise intervention, and following CT intervention). Linear mixed effects modeling examined exercise group differences across time periods in an intention-to-treat analysis.
Both aquatic- and land-based exercise with CT interventions resulted in significant improvement in learning and memory outcomes, though improvement in executive functioning, processing speed, language, and visuospatial abilities was limited to water-based and CT treatment groups. Differences in linear growth patterns between groups were nonsignificant.
Results suggest that for older adults with MCI to obtain global cognitive benefits (ie, learning and memory, executive functioning, processing speed, language, and visuospatial abilities) using combined exercise and CT interventions, they must be able to fully engage in exercise, and aquatic-based activities should be further considered.
轻度认知障碍 (MCI) 的诊断提出了干预的关键时期。尽管运动和认知训练 (CT) 干预已报告在改善认知方面取得了独立的成功，但一些荟萃分析表明，联合干预提供了最大的益处。以前的许多研究都研究了陆地运动而非水上运动，这对老年人构成了潜在的障碍。本研究的目的是检验联合运动（水上或陆上）和 CT 治疗对 MCI 老年患者认知的影响。
参与者为 67 名年龄在 54-86 岁之间的 MCI 成年人，他们接受了 6 个月的陆地或水上运动，随后在 4 周内进行 CT。主要的结果变量是 3 个时间点（基线、运动干预后和 CT 干预后）几个认知领域的表现测量。线性混合效应模型在意向治疗分析中检查了治疗期间的运动组差异。
水上和陆地运动与 CT 干预均导致学习和记忆结果显著改善，尽管执行功能、处理速度、语言和视空间能力的改善仅限于水上和 CT 治疗组。组间线性增长模式的差异无统计学意义。
结果表明，对于 MCI 老年患者来说，要获得全面的认知益处（即学习和记忆、执行功能、处理速度、语言和视空间能力），需要通过联合运动和 CT 干预，他们必须能够充分参与运动，并且应该进一步考虑水上活动。
