Simultaneous Aerobic Exercise and Memory Training Program in Older Adults with Subjective Memory Impairments

Sarah C McEwen, Prabha Siddarth, Berna Rahi, Yena Kim, Wenli Mui, Pauline Wu, Natacha D Emerson, Jacob Lee, Shayna Greenberg, Tiffany Shelton, Scott Kaiser, Gary W Small, David A Merrill, Sarah C McEwen, Prabha Siddarth, Berna Rahi, Yena Kim, Wenli Mui, Pauline Wu, Natacha D Emerson, Jacob Lee, Shayna Greenberg, Tiffany Shelton, Scott Kaiser, Gary W Small, David A Merrill

Abstract

Background: Several modifiable lifestyle factors have been shown to have potential beneficial effects in slowing cognitive decline. Two such factors that may affect cognitive performance and slow the progression of memory loss into dementia in older adults are cognitive training and physical activity. There are currently no effective treatments for dementia; therefore, preventative strategies to delay or prevent the onset of dementia are of critical importance.

Objective: The aim of this study was to determine the relative effectiveness of simultaneous performance of memory training and aerobic exercise to a sequential performance intervention on memory functioning in older adults.

Methods: 55 older adults (aged 60- 75) with subjective memory impairments (non-demented and non-MCI) completed the intervention that consisted of 90-minute small group classes held twice weekly. Participants were randomized to either 4-weeks of supervised strategy-based memory training done simultaneously while stationary cycling (SIM) or sequentially after the stationary cycling (SEQ). Standardized neurocognitive measures of memory, executive functioning, speed of processing, attention, and cognitive flexibility were assessed at baseline and post-intervention.

Results: The SIM group, but not the SEQ group, had a significant improvement on composite memory following the intervention (t(51) = 2.7, p = 0.01, effect size (ES) = 0.42) and transfer to non-trained reasoning abilities (t(51) = 6.0, ES = 0.49) and complex attention (t(51) = 3.1, p = 0.003, ES = 0.70). Conversely, the SEQ group, but not the SIM, showed significant improvement in executive functioning (t(51) = 5.0, p = 0.0001, ES = 0.96).

Conclusion: These findings indicate that a 4-week simultaneous memory training and aerobic exercise program is sufficient to improve memory, attention, and reasoning abilities in older adults.

Trial registration: ClinicalTrials.gov NCT02433691.

Keywords: Aerobic exercise; Alzheimer’s disease; cognitive decline; cognitive training; dementia; memory training; physical activity; subjective memory complaints.

Figures

Fig.1
Fig.1
Composition of the small group, trainer led, simultaneous (SIM) exercise and memory training or sequential (SEQ) exercise then memory training, 2-hour training sessions.
Fig.2
Fig.2
Simultaneous (SIM) exercise and memory training session set-up. After completing 1 hour of stretch and tone (non-aerobic warm-up) movements to control for participant time in the sequential (SEQ) arm, SIM participants would complete their combined exercise session where they would have a 20-minute introduction to the memory training session for the day on the bike but not cycling (non-aerobic/sedentary). Then they would start pedaling on the stationary bike for 40 minutes of stationary, aerobic cycling (@ 65% HRR) while learning the memory strategies and practicing the memory drills which were presented by the trainer on the screen in front of the class, this was followed by 5 minutes of cool-down on the bike.
Fig.3
Fig.3
CONSORT diagram and participant’s flow.
Fig.4
Fig.4
Cognitive performance in Composite memory and Executive Functioning standard scores from baseline to immediately post-intervention for the simultaneous exercise and memory training (SIM) and sequential exercise and memory training (SEQ) groups. Error bars represent 95% confidence limits.

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Source: PubMed

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