居家锻炼单独或联合认知训练对社区老年人认知功能的影响：一项随机临床试验。

Effects of home-based exercise alone or combined with cognitive training on cognition in community-dwelling older adults: A randomized clinical trial.

作者信息

Dupuy Emma Gabrielle, Besnier Florent, Gagnon Christine, Vincent Thomas, Vrinceanu Tudor, Blanchette Caroll-Ann, Gervais Jeremy, Breton Juliana, Saillant Kathia, Iglesies-Grau Josep, Belleville Sylvie, Juneau Martin, Vitali Paolo, Nigam Anil, Gayda Mathieu, Bherer Louis

机构信息

Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.

出版信息

Exp Gerontol. 2024 Dec;198:112628. doi: 10.1016/j.exger.2024.112628. Epub 2024 Nov 9.

DOI:10.1016/j.exger.2024.112628

PMID:39505286

Abstract

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, η = 0.050). Group x Exercise dose interaction was observed for episodic memory Z-score change (F = 6.736, p = 0.011, η = 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 = 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.

摘要

背景

结构化且有监督的体育锻炼和认知训练是增强老年人认知能力的两种有效方法。在联合干预中同时进行这两种训练，由于它们对大脑功能可能存在协同作用，可能会使它们对认知的影响最大化。在新冠疫情期间，由于社交限制对身体活动和认知刺激水平产生的附带影响，这些干预措施尤为重要。然而，远程监测的体育锻炼与认知训练相结合的干预措施对老年人认知的益处仍有待证明。

方法

127名老年人（年龄：65.20 ± 7.95）被随机分为两组，一组鼓励他们在六个月内自行进行居家体育锻炼，另一组则是体育锻炼与认知训练相结合，每周通过电话进行一次监测。在基线时以及三个月和六个月后，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、工作记忆和情景记忆的综合Z分数，以评估训练三个月和六个月后的变化。使用体力活动纲要估计自我报告活动的每周代谢消耗，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，与仅进行锻炼的参与者相比，联合组参与者的执行功能Z分数变化更大（F = 4.127，p = 0.046，η = 0.050）。在情景记忆Z分数变化方面观察到组×运动剂量交互作用（F = 6.736，p = 0.011，η = 0.070），仅在单独锻炼组中，进行高剂量运动的参与者比进行低剂量运动的参与者改善更大。与低剂量相比，在两个干预组中，进行高剂量运动均增加了工作记忆Z分数变化（F = 7.391，p = 0.008，η = 0.076）。