Effect of Dual Task Exercise on Cognitive and Physical Function in the Elderly With Mild Cognitive Impairment

Effect of Dual-task Exercise on Cognitive and Physical Function in the Elderly With Mild Cognitive Impairment: a Randomized Controlled Trial

The purpose of this study is to investigate the effect of the dual task exercise program on cognitive and physical function in the elderly with mild cognitive impairment.

Study Overview

• Status: Completed
• Conditions: Cognitive Dysfunction; Mild Cognitive Impairment
• Intervention / Treatment: Behavioral: dual task exercise; Behavioral: home exercise

Detailed Description

All participants provided written informed consent before study participation. A total of 12 community-dwelling participants were randomized either to the exercise group or to the control group.

The exercise group underwent 8-week, 3 times a week, 60-minute group exercise sessions, which were comprised of moderate-to-high intensity exercise and simultaneous cognitive tasks. They also performed moderate-intensity home aerobic exercises for at least 60 minutes per week. The control group performed 60-minute light intensity home exercise, 4 times a week for 8 weeks.

• Study Type: Interventional
• Enrollment (Actual): 12
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Korea, Republic of
  • Seoul, Korea, Republic of, 07061
    • Seoul National University Boramae Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• a score on the Korean Montreal Cognitive Assessment (MoCA-K) of 25 points or below
• aged 65 or more
• no physical or medical problem which impairs moderate to vigorous physical activity

Exclusion Criteria:

• uncontrolled or unstable cardiovascular disease
• malignancy affecting general condition
• musculoskeletal problems affecting motor performance
• speech and hearing impairment
• other organic brain diseases

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: The exercise group; The exercise group underwent 8-week, 3 times a week, 60-minute group exercise sessions, which were comprised of moderate-to-high intensity exercise and simultaneous cognitive tasks. The exercise group also performed moderate-intensity home aerobic exercises for at least 60 minutes per week.	Behavioral: dual task exercise; 8-week, 3 times a week, 60-minute group exercise sessions, which were comprised of moderate-to-high intensity exercise and simultaneous cognitive tasks
Other: The control group; The control group performed 60-minute light intensity home exercise, 4 times a week for 8 weeks.	Behavioral: home exercise; 60-minute light intensity home exercise, 4 times a week for 8 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Dual task cost in Timed up and go (TUG)	Participants completed both single-task (ST) and dual-task (DT) tests at baseline and post-intervention. For a ST condition, participants performed motor task only such as Timed up and go (TUG). TUG measured the time of taking to rise from a chair, walking three meters, turning around 180 degrees, walking back to the chair, and sitting down while turning 180 degrees. For a DT condition, participants performed TUG while performing serial 3 simultaneously. Serial 3 is descending subtraction task, where the patient counts down from one hundred by threes. In the DT condition, participants were given no instruction regarding the prioritization of one task over the other. We calculated TUG duration in both conditions. Dual task cost(DTC) were calculated as a percentage as follows: (%DTC) = [dual task duration or speed - single task duration or speed] / [single task duration or speed] * 100%. The lower DTC indicates efficiency in cognitive-motor interplay and good dual task ability.	Baseline
Dual task cost in 10-meter walking test	Participants completed both single-task (ST) and dual-task (DT) tests at baseline and post-intervention. For a ST condition, participants performed motor task only such as 10-meter walking test (10MWT). 10MWT is a performance measure used to assess walking speed over a short distance. For a DT condition, participants performed 10MWT while performing serial 3 simultaneously. Serial 3 is descending subtraction task, where the patient counts down from one hundred by threes. In the DT condition, participants were given no instruction regarding the prioritization of one task over the other. We calculated 10MWT gait speed in both conditions. Dual task cost(DTC) were calculated as a percentage as follows: (%DTC) = [dual task duration or speed - single task duration or speed] / [single task duration or speed] * 100%. The lower DTC indicates efficiency in cognitive-motor interplay and good dual task ability.	Baseline
Dual task cost in Timed up and go (TUG)	Participants completed both single-task (ST) and dual-task (DT) tests at baseline and post-intervention. For a ST condition, participants performed motor task only such as Timed up and go (TUG). TUG measured the time of taking to rise from a chair, walking three meters, turning around 180 degrees, walking back to the chair, and sitting down while turning 180 degrees. For a DT condition, participants performed TUG while performing serial 3 simultaneously. Serial 3 is descending subtraction task, where the patient counts down from one hundred by threes. In the DT condition, participants were given no instruction regarding the prioritization of one task over the other. We calculated TUG duration in both conditions. Dual task cost(DTC) were calculated as a percentage as follows: (%DTC) = [dual task duration or speed - single task duration or speed] / [single task duration or speed] * 100%. The lower DTC indicates efficiency in cognitive-motor interplay and good dual task ability.	immediately after the 8-week intervention
Dual task cost in 10-meter walking test	Participants completed both single-task (ST) and dual-task (DT) tests at baseline and post-intervention. For a ST condition, participants performed motor task only such as 10-meter walking test (10MWT). 10MWT is a performance measure used to assess walking speed over a short distance. For a DT condition, participants performed 10MWT while performing serial 3 simultaneously. Serial 3 is descending subtraction task, where the patient counts down from one hundred by threes. In the DT condition, participants were given no instruction regarding the prioritization of one task over the other. We calculated 10MWT gait speed in both conditions. Dual task cost(DTC) were calculated as a percentage as follows: (%DTC) = [dual task duration or speed - single task duration or speed] / [single task duration or speed] * 100%. The lower DTC indicates efficiency in cognitive-motor interplay and good dual task ability.	immediately after the 8-week intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Korean Montreal Cognitive Assessment (MoCA-K)	MoCA-K is a screening test to assess cognitive functions such as attention, concentration, execution, memory, vocabulary, visual space, abstraction, and calculation. MoCA-K is a test for mild cognitive impairment and it takes about 10 minutes to run. It assesses cognitive functions such as attention, concentration, execution, memory, vocabulary, visual space, abstraction, calculation and support. Of a maximum 30 points, a score of 25 or higher is considered normal.	Baseline
Korean Montreal Cognitive Assessment (MoCA-K)	MoCA-K is a screening test to assess cognitive functions such as attention, concentration, execution, memory, vocabulary, visual space, abstraction, and calculation. MoCA-K is a test for mild cognitive impairment and it takes about 10 minutes to run. It assesses cognitive functions such as attention, concentration, execution, memory, vocabulary, visual space, abstraction, calculation and support. Of a maximum 30 points, a score of 25 or higher is considered normal.	immediately after the 8-week intervention
Korean Mini Mental Status Examination (K-MMSE)	K-MMSE is a screening test for dementia that can evaluate various areas of cognitive function in a short time of 5 to 10 minutes such as time orientation, place orientation, memory, attention and calculation, understanding and judgment, and language. Of a maximum 30 points, a score of less than 24 is considered dementia.	Baseline
Korean Mini Mental Status Examination (K-MMSE)	K-MMSE is a screening test for dementia that can evaluate various areas of cognitive function in a short time of 5 to 10 minutes such as time orientation, place orientation, memory, attention and calculation, understanding and judgment, and language. Of a maximum 30 points, a score of less than 24 is considered dementia.	immediately after the 8-week intervention
Computerized cognitive test(digit span test, visual learning test, verbal learning test, the Stroop Color and Word test, Boston naming test, trail making test, and verbal fluency test)	Computerized cognitive test is a test method which quantitatively measures patients' cognitive problems in a systematic and standardized manner using a computer. Various neurocognitive function tests such as attention, memory, memory-motor coordination, and comprehensive cognitive thinking ability are possible through computerized cognitive test. Card sorting test, digit span test, visual learning test, verbal learning test, and Stroop word color test were conducted for precise cognitive function evaluation.	Baseline
Computerized cognitive test(digit span test, visual learning test, verbal learning test, the Stroop Color and Word test, Boston naming test, trail making test, and verbal fluency test)	Computerized cognitive test is a test method which quantitatively measures patients' cognitive problems in a systematic and standardized manner using a computer. Various neurocognitive function tests such as attention, memory, memory-motor coordination, and comprehensive cognitive thinking ability are possible through computerized cognitive test. Card sorting test, digit span test, visual learning test, verbal learning test, and Stroop word color test were conducted for precise cognitive function evaluation.	immediately after the 8-week intervention
Short Physical Performance Battery (SPPB)	SPPB is a group of measures that combines the results of the gait speed, chair stand and balance tests. It has been used as a predictive tool for possible disability and can aid in the monitoring of function in older people . The scores range from 0 (worst performance) to 12 (best performance).	Baseline
Short Physical Performance Battery (SPPB)	SPPB is a group of measures that combines the results of the gait speed, chair stand and balance tests. It has been used as a predictive tool for possible disability and can aid in the monitoring of function in older people . The scores range from 0 (worst performance) to 12 (best performance).	immediately after the 8-week intervention
Berg Balance Scale (BBS)	BBS is an evaluation tool designed to measure the balance of the elderly and consists of 56 points in 14 items that apply daily life movements. It is a measure to objectively evaluate static and dynamic balance ability in various postures such as sitting, standing, and posture change. Higher score means well balance function.	Baseline
Berg Balance Scale (BBS)	BBS is an evaluation tool designed to measure the balance of the elderly and consists of 56 points in 14 items that apply daily life movements. It is a measure to objectively evaluate static and dynamic balance ability in various postures such as sitting, standing, and posture change. Higher score means well balance function.	immediately after the 8-week intervention
Falls Efficacy Scale (FES)	FES is a questionnaire that evaluates the confidence to perform the activities without falling from the 10 activities. Higher score means good function.	Baseline
Falls Efficacy Scale (FES)	FES is a questionnaire that evaluates the confidence to perform the activities without falling from the 10 activities. Higher score means good function.	immediately after the 8-week intervention
Activities-specific Balance Confidence (ABC)	ABC consists of 16 surveys and it evaluates level of self-confidence in doing the activity without losing balance or becoming unsteady by choosing one of the percentage points on the scale from 0% to 100%.	Baseline
Activities-specific Balance Confidence (ABC)	ABC consists of 16 surveys and it evaluates level of self-confidence in doing the activity without losing balance or becoming unsteady by choosing one of the percentage points on the scale from 0% to 100%.	immediately after the 8-week intervention
Grip strength	Grip strength was measured by hand dynamometer for evaluating muscle strength. It is measured using pound(lb).	Baseline
Grip strength	Grip strength was measured by hand dynamometer for evaluating muscle strength. It is measured using pound(lb).	immediately after the 8-week intervention
Korean version of Physical Activity Scale for the Elderly (K-PASE)	K-PASE measures various physical activities of the elderly which are divided into sedentary life, leisure time activities, housework activities, and work-related activities. The score is calculated by multiplying the level and frequency of each activity using the conversion table. Higher score means higher activity.	Baseline
Korean version of Physical Activity Scale for the Elderly (K-PASE)	K-PASE measures various physical activities of the elderly which are divided into sedentary life, leisure time activities, housework activities, and work-related activities. The score is calculated by multiplying the level and frequency of each activity using the conversion table. Higher score means higher activity.	during intervention(8 weeks)
International Physical Activity Questionnaires Short form (IPAQ)	IPAQ Short form consists of 7 surveys and evaluate the degree of physical activity and the time spent on physical activity for one week.	Baseline
International Physical Activity Questionnaires Short form (IPAQ)	IPAQ Short form consists of 7 surveys and evaluate the degree of physical activity and the time spent on physical activity for one week.	during intervention (8 weeks)
Metabolic Equivalent Task (MET) minutes per week	MET minutes per week were evaluated to measure the degree of physical activity before intervention and every week during 8 weeks of intervention. MET minutes per week was calculated based on IPAQ.	Baseline
Metabolic Equivalent Task (MET) minutes per week	MET minutes per week were evaluated to measure the degree of physical activity before intervention and every week during 8 weeks of intervention. MET minutes per week was calculated based on IPAQ.	during intervention(8 weeks)
Bioelectrical Impedance Analysis	Bioelectrical Impedance Analysis was evaluated using Inbody for changes in body composition before and after intervention. Specifically, body weight, body fat percent, body mass index (BMI), skeletal muscle mass, lean mass, fat mass, waist hip ratio were evaluated.	Baseline
Bioelectrical Impedance Analysis	Bioelectrical Impedance Analysis was evaluated using Inbody for changes in body composition before and after intervention. Specifically, body weight, body fat percent, body mass index (BMI), skeletal muscle mass, lean mass, fat mass, waist hip ratio were evaluated.	immediately after the 8-week intervention
Exercise Identity Scale (EIS)	Exercise Identity Scale (EIS) is a measure of how important exercise is in daily life	Baseline
Exercise Identity Scale (EIS)	Exercise Identity Scale (EIS) is a measure of how important exercise is in daily life	immediately after the 8-week intervention
Psychological Need Satisfaction in Exercise Scale (PNSE)	Psychological Need Satisfaction in Exercise Scale (PNSE) is an exercise psychological measure consisting of detailed items of self-confidence, autonomy, and belonging related to exercise.	Baseline
Psychological Need Satisfaction in Exercise Scale (PNSE)	Psychological Need Satisfaction in Exercise Scale (PNSE) is an exercise psychological measure consisting of detailed items of self-confidence, autonomy, and belonging related to exercise.	immediately after the 8-week intervention
Godin Leisure Time Exercise Questionnaire (GLTEQ)	Godin Leisure Time Exercise Questionnaire (GLTEQ) is a self-report measure of the frequency of light-intensity, moderate-intensity, and vigorous-intensity leisure-time physical activity. It evaluated how satisfied the participants were with the intervention.	Baseline
Godin Leisure Time Exercise Questionnaire (GLTEQ)	Godin Leisure Time Exercise Questionnaire (GLTEQ) is a self-report measure of the frequency of light-intensity, moderate-intensity, and vigorous-intensity leisure-time physical activity. It evaluated how satisfied the participants were with the intervention.	immediately after the 8-week intervention

Collaborators and Investigators

• Sponsor: Seoul National University Boramae Hospital
• Collaborators: National Rehabilitation Center, Ministry of Health and Welfare, Korea
• Investigators: Study Chair: Se Hee Jung, MD, PhD, Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center

Publications and helpful links

General Publications

• Plummer P, Eskes G. Measuring treatment effects on dual-task performance: a framework for research and clinical practice. Front Hum Neurosci. 2015 Apr 28;9:225. doi: 10.3389/fnhum.2015.00225. eCollection 2015.

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2020
• Primary Completion (Actual): September 30, 2020
• Study Completion (Actual): April 8, 2021

Study Registration Dates

• First Submitted: March 30, 2023
• First Submitted That Met QC Criteria: May 9, 2023
• First Posted (Estimate): May 11, 2023

Study Record Updates

• Last Update Posted (Estimate): May 11, 2023
• Last Update Submitted That Met QC Criteria: May 9, 2023
• Last Verified: May 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Neurocognitive Disorders; Cognition Disorders; Cognitive Dysfunction
• Other Study ID Numbers: 20-2020-38

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No