Evolving methods to combine cognitive and physical training for individuals with mild cognitive impairment: study protocol for a randomized controlled study

Abstract

BackgroundNonpharmacologic interventions, such as cognitive training or physical exercise, are effective in improving cognitive functions for older adults with mild cognitive impairment (MCI). Some researchers have proposed that combining physical exercise with cognitive training may augment the benefits of cognition. However, strong evidence is lacking regarding whether a combined therapy is superior to a single type of training for older adults with MCI. Moreover, which combination approach – combining physical exercise with cognitive training sequentially or simultaneously – is more advantageous for cognitive improvement is not yet clear. This proposed study is designed to clarify these questions.Methods/designThis study is a single-blinded, multicenter, randomized controlled trial. Eighty individuals with MCI will be recruited and randomly assigned to cognitive training (COG), physical exercise training (PE), sequential training (SEQ), and dual-task training (DUAL) groups. The intervention programs will be 90 min/day, 2–3 days/week, for a total of 36 training sessions. The participants in the SEQ group will first perform 45 min of physical exercise followed by 45 min of cognitive training, whereas those in the DUAL group will perform physical exercise and cognitive training simultaneously. Participants will be assessed at baseline, after the intervention, and at 6-month follow-up. The primary cognitive outcome tests will include the Montreal Cognitive Assessment and the color-naming Stroop test. Other outcomes will include assessments that evaluate the cognitive, physical, and daily functions of older adults with MCI.DiscussionThe results of this proposed study will provide important information regarding the feasibility and intervention effects of combining physical exercise and cognitive training for older individuals with MCI.Trial registrationClinicalTrials.gov Identifier: NCT02512627, registered on 20 July 2015.

The Aerobic and Cognitive Exercise Study (ACES) for Community-Dwelling Older Adults With or At-Risk for Mild Cognitive Impairment (MCI): Neuropsychological, Neurobiological and Neuroimaging Outcomes of a Randomized Clinical Trial

“…Preliminary results from single bout use of our prototype iPACES™ have been promising (Anderson-Hanley et al, 2017 ), and we hope these various studies will encourage others to identify, design, and implement novel behavioral interventions to combat and ameliorate cognitive decline. Indeed there are a number of other open protocols currently recruiting to innovative behavioral interventions (Legault et al, 2011 ; Lee et al, 2016 ); for example, the Aerobic Exercise and Cognitive Training Trial (ACT) out of the University of Minnesota is enrolling patients with MCI to better understand the benefit of combined physical and mental activities (NCT03313895), and the Multidomain Alzheimer Prevention Trial (MAPT) combines physical and cognitive exercise, while also layering a nutritional component that may be able to further maximize any cognitive benefit derived (Vellas et al, 2014 ). Some research teams have been pushing the envelope on the possibilities given advancing technologies and have even explored web-connected exergaming to facilitate participation (Bamidis et al, 2011 ; Konstantinidis et al, 2017 ).…”

Combining 3D-MOT with motor and perceptual decision-making tasks: conception of a life-sized virtual perceptual-cognitive training paradigm

“…These results raised the importance of consolidated training before the engagement in simultaneous training for rapid performance enhancement, especially if a variety of skills have to be mastered (Quevedo, Blázquez et al 2015). A few studies have tried to compare sequential and simultaneous trainings; for a methodological example, see the ongoing work by Lee and colleagues (2016) in patients with mild cognitive impairment (Lee, Wu et al 2016). In the sport domain, there is very few comparisons between the simultaneous and sequential approaches.…”

Development and validation of a dementia screening tool for primary care in Taiwan: Brain Health Test

“…Besides the high sensitivity and specificity, the high NPV of BHT is another benefit. This means that if mass opportunistic screenings during community health checks are performed with BHT, community-based non-pharmacologic therapy, such as cognitive occupational therapy[ 45 , 46 ], reminiscence therapy[ 47 – 49 ], exercise therapy[ 45 , 50 ], etc., which have been developed to stimulate cognitive abilities, slow cognitive deterioration, reduce problematic behaviors, and improve the quality of life for patients with dementia, could be provided as soon as possible.…”