Background:
Identifying strategies to mitigate age-associated cognitive decline is crucial. High-velocity power training enhances physical function in older adults and cognitive training has mixed cognitive benefits, however the combined effects of these interventions remain uncertain.
Objective:
This 18-month cluster randomized controlled trial investigated whether dual-task functional power training (DT-FPT) enhances cognition in older adults and assessed if responses differ by apolipoprotein-E and brain-derived neurotrophic factor (BDNF) polymorphisms.
Subjects and methods:
Twenty-two independent-living retirement communities (300 residents, ≥65y at increased falls risk) were randomized to 12-months of group-based DT-FPT (6-months supervised +6-months maintenance, 45-60 minutes, 2/week) performed simultaneously with cognitive and/or motor tasks, followed by 6-months follow-up, or usual care control (CON). Cognitive domains were assessed using CogState at baseline, 6, 12 and 18-months. Z-scores were created to form composites for psychomotor-attention, learning-working memory and global cognition. BDNF and APOE polymorphism data were obtained from blood samples.
Results:
Overall, 223 (74%) participants completed the 18-month intervention; mean exercise adherence was 50% at 6-months and 40% at 12-months. Net benefits in choice reaction time and attention (0.17 SD, P = 0.016), psychomotor-attention (0.19 SD, P = 0.029), and a composite of psychomotor-attention, learning-working memory (0.11 SD, P = 0.046) were detected in DT-FPT vs CON after the 6-month supervised phase. At 12 and 18 months, benefits from DT-FPT relative to CON were extended to visual learning (0.29 SD, P = 0.013; 0.27 SD, P = 0.008) and learning-working memory (0.13 SD, P = 0.047; 0.18 SD, P = 0.013). CON exhibited a 0.19 SD net benefit for executive function (P = 0.003) after 18 months. BDNF Met carriers at 18 months showed improved working memory (0.35 SD, P = 0.042) and learning-working memory (0.37 SD, P = 0.011) in DT-FPT versus CON.
Conclusions:
In older retirement living residents, DT-FPT may improve cognitive domains critical for functional independence, with genotype potentially influencing these outcomes.
