Abstract
Importance
Although participation in physical and cognitive activities is encouraged to reduce
the risk of dementia, the preventive efficacy of these activities for patients with
mild cognitive impairment is unestablished.
Objective
To compare the cognitive and mobility effects of a 40-week program of combined cognitive
and physical activity with those of a health education program.
Design
A randomized, parallel, single-blind controlled trial.
Setting
A population-based study of participants recruited from Obu, a residential suburb
of Nagoya, Japan.
Participants
Between August 2011 and February 2012, we evaluated 945 adults 65 years or older with
mild cognitive impairment, enrolled 308, and randomly assigned them to the combined
activity group (n = 154) or the health education control group (n = 154).
Interventions
The combined activity program involved weekly 90-minute sessions for 40 weeks focused
on physical and cognitive activities. The control group attended 90-minute health
promotion classes thrice during the 40-week trial period.
Measurement
The outcome measures were assessed at the study's beginning and end by personnel blinded
to mild cognitive impairment subtype and group. The primary endpoints were postintervention
changes in scores on (1) the Mini-Mental State Examination as a measure of general
cognitive status and memory, (2) the Wechsler Memory Scale-Revised–Logical Memory
II, and (3) the Rey Auditory Verbal Learning Test. We applied mobility assessments
and assessed brain atrophy with magnetic resonance imaging.
Results
Compared with the control group, the combined activity group showed significantly
greater scores on the Mini-Mental State Examination (difference = 0.8 points, P = .012) and Wechsler Memory Scale-Revised–Logical Memory II (difference = 1.0, P = .004), significant improvements in mobility and the nonmemory domains and reduced
left medial temporal lobe atrophy in amnestic mild cognitive impairment (Z-score difference = −31.3, P < .05).
Conclusion
Combined physical and cognitive activity improves or maintains cognitive and physical
performance in older adults with mild cognitive impairment, especially the amnestic
type.
Keywords
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Article info
Publication history
Published online: November 16, 2017
Footnotes
The authors declare no conflicts of interest.
The study was funded by grants including Health and Labor Sciences Research Grants (Comprehensive Research on Aging and Health), a Grant-in-Aid for Scientific Research (B) (grant number 23300205), and Research Funding for Longevity Sciences (22-16) from the National Center for Geriatrics and Gerontology, Japan. All researchers acted independently of the funding bodies. The funding bodies had no role in the study design, data collection, data analysis and interpretation, or report writing.
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