Effects of combined physical and cognitive training on fitness and neuropsychological outcomes in healthy older adults

Laurence Desjardins-Crépeau, Nicolas Berryman, Sarah A Fraser, Thien Tuong Minh Vu, Marie-Jeanne Kergoat, Karen Zh Li, Laurent Bosquet, Louis Bherer, Laurence Desjardins-Crépeau, Nicolas Berryman, Sarah A Fraser, Thien Tuong Minh Vu, Marie-Jeanne Kergoat, Karen Zh Li, Laurent Bosquet, Louis Bherer

Abstract

Purpose: Physical exercise and cognitive training have been shown to enhance cognition among older adults. However, few studies have looked at the potential synergetic effects of combining physical and cognitive training in a single study. Prior trials on combined training have led to interesting yet equivocal results. The aim of this study was to examine the effects of combined physical and cognitive interventions on physical fitness and neuropsychological performance in healthy older adults.

Methods: Seventy-six participants were randomly assigned to one of four training combinations using a 2×2 factorial design. The physical intervention was a mixed aerobic and resistance training program, and the cognitive intervention was a dual-task (DT) training program. Stretching and toning exercises and computer lessons were used as active control conditions. Physical and cognitive measures were collected pre- and postintervention.

Results: All groups showed equivalent improvements in measures of functional mobility. The aerobic-strength condition led to larger effect size in lower body strength, independently of cognitive training. All groups showed improved speed of processing and inhibition abilities, but only participants who took part in the DT training, independently of physical training, showed increased task-switching abilities. The level of functional mobility after intervention was significantly associated with task-switching abilities.

Conclusion: Combined training did not yield synergetic effects. However, DT training did lead to transfer effects on executive performance in neuropsychological tests. Both aerobic-resistance training and stretching-toning exercises can improve functional mobility in older adults.

Keywords: aging; cognitive performance; combined intervention; dual task; executive functions; physical performance.

References

    1. Hertzog C, Kramer AF, Wilson RS, Lindenberger U. Erichment effects on adult cognitive development: can the functional capacity of older adults be preserved and enhanced? Psychol Sci Public Interest. 2009;9(1):1–65.
    1. Ballesteros S, Kraft E, Santana S, Tziraki C. Maintaining older brain functionality: a targeted review. Neurosci Biobehav Rev. 2015;55:453–477.
    1. Bherer L. Cognitive plasticity in older adults: effects of cognitive training and physical exercise. Ann N Y Acad Sci. 2015;1337:1–6.
    1. Etnier JL, Nowell PM, Landers DM, Sibley BA. A meta-regression to examine the relationship between aerobic fitness and cognitive performance. Brain Res Rev. 2006;52(1):119–130.
    1. Dupuy O, Gauthier CJ, Fraser SA, et al. Higher levels of cardiovascular fitness are associated with better executive function and prefrontal oxygenation in younger and older women. Front Hum Neurosci. 2015;9:66.
    1. Voelcker-Rehage C, Godde B, Staudinger UM. Physical and motor fitness are both related to cognition in old age. Eur J Neurosci. 2010;31(1):167–176.
    1. Barnes DE, Yaffe K, Satariano WA, Tager IB. A longitudinal study of cardiorespiratory fitness and cognitive function in healthy older adults. J Am Geriatr Soc. 2003;51(4):459–465.
    1. Sofi F, Valecchi D, Bacci D, et al. Physical activity and risk of cognitive decline: a meta-analysis of prospective studies. J Intern Med. 2011;269(1):107–117.
    1. Smith PJ, Blumenthal JA, Hoffman BM, et al. Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials. Psychosom Med. 2010;72(3):239–252.
    1. Colcombe S, Kramer AF. Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci. 2003;14(2):125–130.
    1. Kramer AF, Hahn S, Cohen NJ, et al. Ageing, fitness and neurocognitive function. Nature. 1999;400(6743):418–419.
    1. Hall CD, Smith AL, Keele SW. The impact of aerobic activity on cognitive function in older adults: a new synthesis based on the concept of executive control. Eur J Cognit Psychol. 2001;13:279–300.
    1. Barenberg J, Berse T, Dutke S. Executive functions in learning processes: do they benefit from physical activity? Educ Res Rev. 2011;6:208–222.
    1. Colcombe SJ, Kramer AF, Erickson KI, et al. Cardiovascular fitness, cortical plasticity, and aging. Proc Natl Acad Sci U S A. 2004;101(9):3316–3321.
    1. Colcombe SJ, Erickson KI, Scalf PE, et al. Aerobic exercise training increases brain volume in aging humans. J Gerontol A Biol Sci Med Sci. 2006;61(11):1166–1170.
    1. Kramer AF, Colcombe S, Erickson K, et al. Effects of aerobic fitness training on human cortical function: a proposal. J Mol Neurosci. 2002;19(1–2):227–231.
    1. Liu-Ambrose T, Nagamatsu LS, Voss MW, Khan KM, Handy TC. Resistance training and functional plasticity of the aging brain: a 12-month randomized controlled trial. Neurobiol Aging. 2012;33(8):1690–1698.
    1. Berryman N, Bherer L, Nadeau S, et al. Multiple roads lead to Rome: combined high-intensity aerobic and strength training vs gross motor activities leads to equivalent improvement in executive functions in a cohort of healthy older adults. Age (Dordr) 2014;36(5):9710.
    1. Chang YK, Pan CY, Chen FT, Tsai CL, Huang CC. Effect of resistance-exercise training on cognitive function in healthy older adults: a review. J Aging Phys Act. 2012;20(4):497–517.
    1. Lustig C, Shah P, Seidler R, Reuter-Lorenz PA. Aging, training, and the brain: a review and future directions. Neuropsychol Rev. 2009;19(4):504–522.
    1. Belleville S, Bherer L. Biomarkers of cognitive training effects in aging. Curr Transl Geriatr Exp Gerontol Rep. 2012;1(2):104–110.
    1. Mowszowski L, Batchelor J, Naismith SL. Early intervention for cognitive decline: can cognitive training be used as a selective prevention technique? Int Psychogeriatr. 2010;22(4):537–548.
    1. Lussier M, Brouillard P, Bherer L. Limited benefits of heterogeneous dual-task training on transfer effects in older adults. J Gerontol B Psychol Sci Soc Sci. 2015 Nov 23; Epub.
    1. Lee H, Boot WR, Basak C, et al. Performance gains from directed training do not transfer to untrained tasks. Acta Psychol (Amst) 2012;139(1):146–158.
    1. Verhaeghen P, Marcoen A, Goossens L. Improving memory performance in the aged through mnemonic training: a meta-analytic study. Psychol Aging. 1992;7(2):242–251.
    1. Rebok GW, Carlson MC, Langbaum JB. Training and maintaining memory abilities in healthy older adults: traditional and novel approaches. J Gerontol B Psychol Sci Soc Sci. 2007;62(Spec No 1):53–61.
    1. Boron JB, Turiano NA, Willis SL, Schaie KW. Effects of cognitive training on change in accuracy in inductive reasoning ability. J Gerontol B Psychol Sci Soc Sci. 2007;62(3):179–186.
    1. Brehmer Y, Westerberg H, Backman L. Working-memory training in younger and older adults: training gains, transfer, and maintenance. Front Hum Neurosci. 2012;6:63.
    1. Li SC, Schmiedek F, Huxhold O, Rocke C, Smith J, Lindenberger U. Working memory plasticity in old age: practice gain, transfer, and maintenance. Psychol Aging. 2008;23(4):731–742.
    1. Roenker DL, Cissell GM, Ball KK, Wadley VG, Edwards JD. Speed-of-processing and driving simulator training result in improved driving performance. Hum Factors. 2003;45(2):218–233.
    1. Edwards JD, Wadley VG, Vance DE, Wood K, Roenker DL, Ball KK. The impact of speed of processing training on cognitive and everyday performance. Aging Ment Health. 2005;9(3):262–271.
    1. Bherer L, Kramer AF, Peterson MS, Colcombe S, Erickson K, Becic E. Training effects on dual-task performance: are there age-related differences in plasticity of attentional control? Psychol Aging. 2005;20(4):695–709.
    1. Kramer AF, Larish JF, Strayer DL. Training for attentional control in dual task settings: a comparison of young and old adults. J Exp Psychol Appl. 1995;1:50–76.
    1. Coelho FG, Andrade LP, Pedroso RV, et al. Multimodal exercise intervention improves frontal cognitive functions and gait in Alzheimer’s disease: a controlled trial. Geriatr Gerontol Int. 2013;13(1):198–203.
    1. Schwenk M, Zieschang T, Oster P, Hauer K. Dual-task performances can be improved in patients with dementia: a randomized controlled trial. Neurology. 2010;74(24):1961–1968.
    1. Suzuki T, Shimada H, Makizako H, et al. Effects of multicomponent exercise on cognitive function in older adults with amnestic mild cognitive impairment: a randomized controlled trial. BMC Neurol. 2012;12:128.
    1. Fabre C, Chamari K, Mucci P, Masse-Biron J, Prefaut C. Improvement of cognitive function by mental and/or individualized aerobic training in healthy elderly subjects. Int J Sports Med. 2002;23(6):415–421.
    1. Oswald WD, Gunzelmann T, Rupprecht R, Hagen B. Differential effects of single versus combined cognitive and physical training with older adults: the SimA study in a 5-year perspective. Eur J Ageing. 2006;3(4):179–192.
    1. Shatil E. Does combined cognitive training and physical activity training enhance cognitive abilities more than either alone? A four-condition randomized controlled trial among healthy older adults. Front Aging Neurosci. 2013;5:8.
    1. Linde K, Alfermann D. Single versus combined cognitive and physical activity effects on fluid cognitive abilities of healthy older adults: a 4-month randomized controlled trial with follow-up. J Aging Phys Act. 2014;22(3):302–313.
    1. Jaeggi SM, Buschkuehl M, Jonides J, Perrig WJ. Improving fluid intelligence with training on working memory. Proc Natl Acad Sci U S A. 2008;105(19):6829–6833.
    1. Karbach J, Mang S, Kray J. Transfer of task-switching training in older age: the role of verbal processes. Psychol Aging. 2010;25(3):677–683.
    1. Miyake A, Friedman NP, Emerson MJ, Witzki AH, Howerter A. The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: a latent variable analysis. Cogn Psychol. 2000;41:49–100.
    1. Cahn-Weiner DA, Malloy PF, Boyle PA, Marran M, Salloway S. Prediction of functional status from neuropsychological tests in community-dwelling elderly individuals. Clin Neuropsychol. 2000;14(2):187–195.
    1. Carlson MC, Fried LP, Xue QL, Bandeen-Roche K, Zeger SL, Brandt J. Association between executive attention and physical functional performance in community-dwelling older women. J Gerontol B Psychol Sci Soc Sci. 1999;54(5):S262–S270.
    1. Royall DR, Palmer R, Chiodo LK, Polk MJ. Declining executive control in normal aging predicts change in functional status: the Freedom House Study. J Am Geriatr Soc. 2004;52(3):346–352.
    1. Johnson JK, Lui LY, Yaffe K. Executive function, more than global cognition, predicts functional decline and mortality in elderly women. J Gerontol A Biol Sci Med Sci. 2007;62(10):1134–1141.
    1. Bell-McGinty S, Podell K, Franzen M, Baird AD, Williams MJ. Standard measures of executive function in predicting instrumental activities of daily living in older adults. Int J Geriatr Psychiatry. 2002;17(9):828–834.
    1. Verhaeghen P, Cerella J. Aging, executive control, and attention: a review of meta-analyses. Neurosci Biobehav Rev. 2002;26(7):849–857.
    1. Holtzer R, Stern Y, Rakitin BC. Predicting age-related dual-task effects with individual differences on neuropsychological tests. Neuropsychology. 2005;19(1):18–27.
    1. Springer S, Giladi N, Peretz C, Yogev G, Simon ES, Hausdorff JM. Dual-tasking effects on gait variability: the role of aging, falls, and executive function. Mov Disord. 2006;21(7):950–957.
    1. Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture. 2002;16(1):1–14.
    1. Bherer L, Kramer AF, Peterson MS, Colcombe S, Erickson K, Becic E. Testing the limits of cognitive plasticity in older adults: application to attentional control. Acta Psychol (Amst) 2006;123(3):261–278.
    1. Bherer L, Kramer AF, Peterson MS, Colcombe S, Erickson K, Becic E. Transfer effects in task-set cost and dual-task cost after dual-task training in older and younger adults: further evidence for cognitive plasticity in attentional control in late adulthood. Exp Aging Res. 2008;34(3):188–219.
    1. Liepelt R, Strobach T, Frensch P, Schubert T. Improved intertask coordination after extensive dual-task practice. Q J Exp Psychol (Hove) 2011;64(7):1251–1272.
    1. Lussier M, Gagnon C, Bherer L. An investigation of response and stimulus modality transfer effects after dual-task training in younger and older. Front Hum Neurosci. 2012;6:129.
    1. Safer DL, Hugo EM. Designing a control for a behavioral group therapy. Behav Ther. 2006;37(2):120–130.
    1. Rahe J, Petrelli A, Kaesberg S, Fink GR, Kessler J, Kalbe E. Effects of cognitive training with additional physical activity compared to pure cognitive training in healthy older adults. Clin Interv Aging. 2015;10:297–310.
    1. Bherer L, Erickson KI, Liu-Ambrose T. A review of the effects of physical activity and exercise on cognitive and brain functions in older adults. J Aging Res. 2013;2013:657508.
    1. Yesavage JA. Geriatric Depression Scale. Psychopharmacol Bull. 1988;24(4):709–711.
    1. Desjardins-Crepeau L, Berryman N, Vu TT, et al. Physical functioning is associated with processing speed and executive functions in community-dwelling older adults. J Gerontol B Psychol Sci Soc Sci. 2014;69(6):837–844.
    1. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–198.
    1. Wechsler D. Wechsler Adult Intelligence Scale – Third Edition: Administration and Scoring Manual. San Antonio, TX: The Psychological Corporation; 1997.
    1. Borg G. Borg’s Perceived Exertion and Pain Scales. Champaign, IL: Human Kinetics; 1998.
    1. Stanziano DC, Roos BA, Perry AC, Lai S, Signorile JF. The effects of an active-assisted stretching program on functional performance in elderly persons: a pilot study. Clin Interv Aging. 2009;4:115–120.
    1. Lezak M, Howison DB, Bigler ED, Tranel D. Neuropsychological Assessment. 5th ed. New York, NY: Oxford University Press; 2012.
    1. Delis DC, Kaplan E, Kramer JH. The Delis-Kaplan Executive Function System: Technical Manual. San Antonio, TX: The Psychological Corporation; 2001.
    1. Stroop JR. Studies of interference in serial verbal reactions. J Exp Psychol. 1935;18:643–661.
    1. Reitan RM. Validity of the trail making test as an indicator of organic brain damage. Percept Mot Skills. 1958;8:271–276.
    1. Della Sala S, Baddeley A, Papagno C, Spinnler H. Dual-task paradigm: a means to examine the central executive. Ann N Y Acad Sci. 1995;769:161–171.
    1. Bautmans I, Lambert M, Mets T. The six-minute walk test in community dwelling elderly: influence of health status. BMC Geriatr. 2004;4:6.
    1. Reuben DB, Siu AL. An objective measure of physical function of elderly outpatients. The Physical Performance Test. J Am Geriatr Soc. 1990;38(10):1105–1112.
    1. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–148.
    1. Gajdosik RL, Vander Linden DW, McNair PJ, Williams AK, Riggin TJ. Effects of an eight-week stretching program on the passive-elastic properties and function of the calf muscles of older women. Clin Biomech (Bristol, Avon) 2005;20(9):973–983.
    1. Boyle PA, Buchman AS, Wilson RS, Leurgans SE, Bennett DA. Association of muscle strength with the risk of Alzheimer disease and the rate of cognitive decline in community-dwelling older persons. Arch Neurol. 2009;66(11):1339–1344.
    1. Predovan D, Fraser SA, Renaud M, Bherer L. The effect of three months of aerobic training on stroop performance in older adults. J Aging Res. 2012;2012:269815.
    1. Angevaren M, Vanhees L, Wendel-Vos W, et al. Intensity, but not duration, of physical activities is related to cognitive function. Eur J Cardiovasc Prev Rehabil. 2007;14(6):825–830.
    1. Brown BM, Peiffer JJ, Sohrabi HR, et al. AIBL Research Group Intense physical activity is associated with cognitive performance in the elderly. Transl Psychiatry. 2012;2:e191.
    1. Tierney MC, Moineddin R, Morra A, Manson J, Blake J. Intensity of recreational physical activity throughout life and later life cognitive functioning in women. J Alzheimers Dis. 2010;22(4):1331–1338.
    1. Erickson KI, Colcombe SJ, Wadhwa R, et al. Training-induced plasticity in older adults: effects of training on hemispheric asymmetry. Neurobiol Aging. 2007;28(2):272–283.
    1. Cassavaugh ND, Kramer AF. Transfer of computer-based training to simulated driving in older adults. Appl Ergon. 2009;40(5):943–952.
    1. Bier B, de Boysson C, Belleville S. Identifying training modalities to improve multitasking in older adults. Age (Dordr) 2014;36(4):9688.
    1. Barnes LL, Mendes de Leon CF, Wilson RS, Bienias JL, Evans DA. Social resources and cognitive decline in a population of older African Americans and whites. Neurology. 2004;63(12):2322–2326.
    1. Lovden M, Ghisletta P, Lindenberger U. Social participation attenuates decline in perceptual speed in old and very old age. Psychol Aging. 2005;20(3):423–434.
    1. Fabrigoule C, Letenneur L, Dartigues JF, Zarrouk M, Commenges D, Barberger-Gateau P. Social and leisure activities and risk of dementia: a prospective longitudinal study. J Am Geriatr Soc. 1995;43(5):485–490.
    1. Wang HX, Karp A, Winblad B, Fratiglioni L. Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: a longitudinal study from the Kungsholmen project. Am J Epidemiol. 2002;155(12):1081–1087.
    1. Law LL, Barnett F, Yau MK, Gray MA. Effects of combined cognitive and exercise interventions on cognition in older adults with and without cognitive impairment: a systematic review. Ageing Res Rev. 2014;15:61–75.
    1. Barnes DE, Santos-Modesitt W, Poelke G, et al. The Mental Activity and eXercise (MAX) trial: a randomized controlled trial to enhance cognitive function in older adults. JAMA Intern Med. 2013;173(9):797–804.
    1. Schaefer S, Schumacher V. The interplay between cognitive and motor functioning in healthy older adults: findings from dual-task studies and suggestions for intervention. Gerontology. 2011;57(3):239–246.
    1. Eggenberger P, Schumacher V, Angst M, Theill N, de Bruin ED. Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up. Clin Interv Aging. 2015;10:1335–1349.
    1. Theill N, Schumacher V, Adelsberger R, Martin M, Jancke L. Effects of simultaneously performed cognitive and physical training in older adults. BMC Neurosci. 2013;14:103.
    1. Kraft E. Cognitive function, physical activity, and aging: possible biological links and implications for multimodal interventions. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2012;19(1–2):248–263.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다