Abstract
Background
Mild cognitive impairment (MCI) increases dementia risk with no pharmacologic treatment
available.
Methods
The Study of Mental and Resistance Training was a randomized, double-blind, double-sham
controlled trial of adults with MCI. Participants were randomized to 2 supervised
interventions: active or sham physical training (high intensity progressive resistance
training vs seated calisthenics) plus active or sham cognitive training (computerized,
multidomain cognitive training vs watching videos/quizzes), 2–3 days/week for 6 months
with 18-month follow-up. Primary outcomes were global cognitive function (Alzheimer's
Disease Assessment Scale-cognitive subscale; ADAS-Cog) and functional independence
(Bayer Activities of Daily Living). Secondary outcomes included executive function,
memory, and speed/attention tests, and cognitive domain scores.
Results
One hundred adults with MCI [70.1 (6.7) years; 68% women] were enrolled and analyzed.
Resistance training significantly improved the primary outcome ADAS-Cog; [relative
effect size (95% confidence interval) −0.33 (−0.73, 0.06); P < .05] at 6 months and executive function (Wechsler Adult Intelligence Scale Matrices;
P = .016) across 18 months. Normal ADAS-Cog scores occurred in 48% (24/49) after resistance
training vs 27% (14/51) without resistance training [P < .03; odds ratio (95% confidence interval) 3.50 (1.18, 10.48)]. Cognitive training
only attenuated decline in Memory Domain at 6 months (P < .02). Resistance training 18-month benefit was 74% higher (P = .02) for Executive Domain compared with combined training [z-score change = 0.42
(0.22, 0.63) resistance training vs 0.11 (−0.60, 0.28) combined] and 48% higher (P < .04) for Global Domain [z-score change = .0.45 (0.29, 0.61) resistance training
vs 0.23 (0.10, 0.36) combined].
Conclusions
Resistance training significantly improved global cognitive function, with maintenance
of executive and global benefits over 18 months.
Keywords
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Article info
Publication history
Published online: October 23, 2014
Footnotes
Registry Protocol No: X08-0064 (Australian and New Zealand Clinical Trials Registry; http://www.anzctr.org.au)
This study was funded by a National Health and Medical Research Council (NH&MRC) of Australia Dementia Research Grant, project grant ID No. 512672 from 2008-2011(https://www.nhmrc.gov.au). Additional funding for a research assistant position was sourced from the NHMRC Program Grant ID No. 568969, and the project was supported by the University of Sydney and University of New South Wales. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. MV was supported by a University of New South Wales Vice Chancellor's Fellowship and a NHMRC Clinical Career Development Fellowship (1004156). This work fulfilled a portion of the degree requirements for PhD for Nicola Gates and Chao Suo.
The authors declare no conflicts of interest.
MV has previously received speaking honoraria and research funding from Pfizer Neuroscience and The Brain Department Pty Ltd. He currently receives in-kind research support from BrainTrain Inc. for work unrelated to this report. HB has been an investigator for Pfizer, Novartis, Janssen, Lilly, Mediation, Sanofi and Servier; a sponsored speaker for Pfizer, Novartis, Janssen and Lundbeck; and is on advisory Boards for Pfizer, Novartis, Janssen, Lundbeck, Merck and Baxter. BB is a member of advisory boards and/or gave presentations for the following companies, for which he has received honoraria: AstraZeneca, Lundbeck, Pfizer, Servier, and Wyeth.
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Copyright
© 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
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- ErratumJournal of the American Medical Directors AssociationVol. 17Issue 8
- PreviewThe authors, Fiatarone Singh MA, Gates N, Saigal N, et al. of the article, The Study of Mental and Resistance Training (SMART) Study—Resistance Training and/or Cognitive Training in Mild Cognitive Impairment: A Randomized, Double-Blind, Double-Sham Controlled Trial. J Am Med Dir Assoc 2014;15:873-880, wish to correct two typographical errors in Table 1 of their article. The errors are in the “Control” column under “ADAS-Cog” and “WAIS Matrices” and the correct numbers are bolded below. The authors regret any misconceptions these errors may have caused.
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- ErratumJournal of the American Medical Directors AssociationVol. 22Issue 2
