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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

Published:October 23, 2014DOI:https://doi.org/10.1016/j.jamda.2014.09.010

      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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      Linked Article

      • Erratum
        Journal of the American Medical Directors AssociationVol. 17Issue 8
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          The 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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      • Erratum
        Journal of the American Medical Directors AssociationVol. 22Issue 2
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          The Authors wish to make a correction to their article published in JAMDA ( https://doi.org/10.1016/j.jamda.2014.09.010 ) “The SMART Study - Resistance Training and/or Cognitive Training in Mild Cognitive Impairment: A Randomized, Double-blind, Double-sham Controlled Trial”.
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