The Effect of Dual Task Training on Cognitive in Alzheimer's Disease

This randomized controlled clinical trial aims to evaluate the effectiveness of dual-task training on cognitive functions in patients with Alzheimer's disease. Participants will be randomly assigned to either a dual-task training group or a conventional exercise group. The intervention will last 8 weeks, with three supervised sessions per week. Cognitive performance, mobility, balance, and quality of life will be assessed before and after the intervention.

Study Overview

• Status: Not yet recruiting
• Conditions: Alzheimer Disease
• Intervention / Treatment: Other: Dual-Task Motor-Cognitive Training; Other: Conventional Exercise Training

Detailed Description

Alzheimer's disease is a progressive neurodegenerative disorder characterized by impairments in memory, executive function, and daily activities. Conventional exercise programs may improve mobility and physical performance, but their impact on cognition is limited. Dual-task training, which integrates motor and cognitive activities simultaneously, has emerged as a promising strategy to enhance neuroplasticity and functional independence in individuals with cognitive decline.

In this study, participants diagnosed with Alzheimer's disease according to standard clinical criteria will be recruited. After baseline assessments, participants will be randomly allocated to one of two groups:

Experimental Group (Dual-Task Training): Participants will perform exercises combining cognitive tasks (e.g., arithmetic, memory recall, word association) with simultaneous motor tasks (e.g., walking, balance training, functional mobility exercises).

Control Group (Conventional Exercise): Participants will engage in standard physical exercises focusing on strength, flexibility, and balance, without added cognitive tasks.

The intervention will span 8 weeks, with three 45-60 minute sessions per week, conducted under supervision by a physiotherapist.

Outcome Measures

Primary Outcomes: Cognitive performance assessed by the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA).

Secondary Outcomes: Functional mobility (Timed Up and Go test), balance (Berg Balance Scale), and quality of life (QoL-AD questionnaire).

Hypothesis

It is hypothesized that dual-task training will lead to greater improvements in cognitive performance and functional independence compared to conventional exercise programs. This study may provide evidence supporting dual-task rehabilitation as a complementary approach in the management of Alzheimer's disease.

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Sümeyye AKÇAY, PhD; Phone Number: +90 542 400 25 53; Email: sumeyye.akcay@fbu.edu.tr
• Study Contact Backup: Name: Burcu AKKURT, PhD; Phone Number: 05536046713; Email: burcu.akkurt@fbu.edu.tr

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Age ≥ 60 years
• Diagnosed with mild-stage Alzheimer's disease (According to DSM-5 or NINCDS-ADRDA criteria)
• MoCA score between 10-25 (Indicating sufficient cognitive capacity for dual-task training)
• Ability to walk independently or with minimal assistance
• Adequate hearing and vision to enable communication
• Physical and mental capacity to participate in the dual-task training protocol
• Provision of written informed consent (signed informed consent form)

Exclusion Criteria:

• Diagnosis of advanced-stage Alzheimer's disease (MoCA < 10)
• Presence of additional neurological disorders affecting the motor system (e.g. Parkinson's disease, stroke, multiple sclerosis)
• Severe hearing or vision impairment (inability to respond to visual or auditory stimuli)
• History of psychiatric disorders (e.g., major depression, schizophrenia)
• Orthopedic or cardiopulmonary conditions that would prevent participation in dual-task training
• Participation in another cognitive or physical rehabilitation program within the last 3 months
• Individuals with unstable cognitive status due to recent medication changes

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Dual-task motor-cognitive training; Participants assigned to this group will undergo dual-task motor-cognitive training, which combines physical exercises with simultaneous cognitive tasks. Sessions will last 45-60 minutes, three times per week, for 8 weeks. Exercises will include gait and balance activities performed while engaging in cognitive tasks such as arithmetic, memory recall, or word association.	Other: Dual-Task Motor-Cognitive Training; Participants assigned to this group will undergo dual-task motor-cognitive training, which combines physical exercises with simultaneous cognitive tasks. Sessions will last 45-60 minutes, three times per week, for 8 weeks. Exercises will include gait and balance activities performed while engaging in cognitive tasks such as arithmetic, memory recall, or word association.
Active Comparator: Conventional Exercise Training; Participants in this group will receive a conventional exercise program focusing on strength, flexibility, and balance without a cognitive component. Sessions will last 45-60 minutes, three times per week, for 8 weeks, and will be supervised by a physiotherapist.	Other: Conventional Exercise Training; Participants in this group will receive a conventional exercise program focusing on strength, flexibility, and balance without a cognitive component. Sessions will last 45-60 minutes, three times per week, for 8 weeks, and will be supervised by a physiotherapist.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
d2 Test of Attention	A widely used neuropsychological test evaluating visual attention and processing speed. Participants are asked to quickly and accurately mark target symbols (e.g., the letter "d" with two dashes) among distractors on a sheet consisting of similar letters and symbols.	From enrollment to the end of treatment at 8 weeks
Trail Making Test Part A (TMT-A)	Assesses visual attention, processing speed, and psychological flexibility. The participant is required to connect numbered circles from 1 to 25 in order as quickly as possible.	From enrollment to the end of treatment at 8 weeks
Stroop Test	Stroop Test: Evaluates executive functions and attentional control. The participant must state the ink color of a word rather than reading the written word itself (e.g., the word "Blue" written in red ink should be answered as "red")	From enrollment to the end of treatment at 8 weeks
Trail Making Test Part B (TMT-B):	Trail Making Test Part B (TMT-B): Used to assess executive functions, cognitive flexibility, and attention. The participant alternates between numbers and letters in sequence (1-A-2-B-3-C…)	From enrollment to the end of treatment at 8 weeks
Montreal Cognitive Assessment (MoCA)	Montreal Cognitive Assessment (MoCA): Evaluates memory, attention, executive functions, and visuospatial skills. It is a standard and validated tool for monitoring cognitive status and comparing pre- and post-intervention performance in Alzheimer's patients	From enrollment to the end of treatment at 8 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Symbol Digit Modalities Test (SDMT)	Symbol Digit Modalities Test (SDMT): Measures processing speed and attention. Participants are presented with a key of symbol-digit pairings and asked to match as many symbols with their corresponding digits as possible within a set time	From enrollment to the end of treatment at 8 weeks
Functional Near-Infrared Spectroscopy (fNIRS)	Functional Near-Infrared Spectroscopy (fNIRS): A non-invasive method to measure prefrontal cortex activation by monitoring oxygenated and deoxygenated hemoglobin levels	From enrollment to the end of treatment at 8 weeks
Disability Assessment for Dementia (DAD)	Disability Assessment for Dementia (DAD): Developed to assess independence in activities of daily living among individuals with dementia. It evaluates both basic and instrumental activities of daily living, including self-care and social functioning	From enrollment to the end of treatment at 8 weeks
Dual Task Protocol	Dual Task Protocol: Participants will perform physical and cognitive tasks simultaneously. For example, during walking, they will be asked to complete word generation, simple arithmetic, or other attention-demanding tasks	From enrollment to the end of treatment at 8 weeks
Performance Measures: Walking speed	Walking speed (measured using a metronome or gait analysis system).	From enrollment to the end of treatment at 8 weeks
Performance Measures: Step count	Step count (measured using a metronome or gait analysis system).	From enrollment to the end of treatment at 8 weeks
Performance Measures: Number of correct response Number of correct responses	Number of correct responses recorded during the secondary cognitive task.	From enrollment to the end of treatment at 8 weeks
Performance Measures: incorrect response	Percentage of incorrect responses recorded during the secondary cognitive task.	From enrollment to the end of treatment at 8 weeks
Gait Analysis System: Walking speed during single-task walking	Provides objective evaluation of walking dynamics using pressure sensors, motion capture systems, or accelerometers.	From enrollment to the end of treatment at 8 weeks
Gait Analysis System: Step length during single-task walking	Provides objective evaluation of walking dynamics using pressure sensors, motion capture systems, or accelerometers.	From enrollment to the end of treatment at 8 weeks
Gait Analysis System:Balance during dual-task walking	Provides objective evaluation of walking dynamics using pressure sensors, motion capture systems, or accelerometers.	From enrollment to the end of treatment at 8 weeks
Gait Analysis System: Postural control during dual-task walking	Provides objective evaluation of walking dynamics using pressure sensors, motion capture systems, or accelerometers.	From enrollment to the end of treatment at 8 weeks
Electromyography (EMG)	Electromyography (EMG): Measures muscle electrical activity through surface electrodes, providing data on contraction duration, activation levels, and coordination (De Luca, 1997). EMG will be used to assess changes in motor control and muscle activation during dual-task training.	From enrollment to the end of treatment at 8 weeks

Collaborators and Investigators

• Sponsor: Fenerbahce University
• Investigators: Principal Investigator: Sümeyye AKÇAY, PhD, Fenerbahce University

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2025
• Primary Completion (Estimated): October 1, 2025
• Study Completion (Estimated): May 1, 2026

Study Registration Dates

• First Submitted: August 21, 2025
• First Submitted That Met QC Criteria: September 1, 2025
• First Posted (Estimated): September 9, 2025

Study Record Updates

• Last Update Posted (Estimated): September 9, 2025
• Last Update Submitted That Met QC Criteria: September 1, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: Alzheimer; Dual-Task Training
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Mental Disorders; Neurocognitive Disorders; Dementia; Tauopathies; Neurodegenerative Diseases; Alzheimer Disease
• Other Study ID Numbers: 63.2025fbu

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