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Combined physical and cognitive training for older adults with and without cognitive impairment: A systematic review and network meta-analysis of randomized controlled trials
journal contributionposted on 2023-02-21, 03:47 authored by HM Gavelin, C Dong, R Minkov, A Bahar-Fuchs, KA Ellis, NT Lautenschlager, ML Mellow, AT Wade, AE Smith, C Finke, S Krohn, A Lampit
Combining physical exercise with cognitive training is a popular intervention in dementia prevention trials and guidelines. However, it remains unclear what combination strategies are most beneficial for cognitive and physical outcomes. We aimed to compare the efficacy of the three main types of combination strategies (simultaneous, sequential or exergaming) to either intervention alone or control in older adults. Randomized controlled trials of combined cognitive and physical training were included in multivariate and network meta-analyses. In cognitively healthy older adults and mild cognitive impairment, the effect of any combined intervention relative to control was small and statistically significant for overall cognitive (k = 41, Hedges’ g = 0.22, 95 % CI 0.14 to 0.30) and physical function (k = 32, g = 0.25, 95 % CI 0.13 to 0.37). Simultaneous training was the most efficacious approach for cognition, followed by sequential combinations and cognitive training alone, and significantly better than physical exercise. For physical outcomes, simultaneous and sequential training showed comparable efficacy as exercise alone and significantly exceeded all other control conditions. Exergaming ranked low for both outcomes. Our findings suggest that simultaneously and sequentially combined interventions are efficacious for promoting cognitive alongside physical health in older adults, and therefore should be preferred over implementation of single-domain training.
JournalAgeing Research Reviews
CognitionCognitive trainingCombined interventionNetwork meta-analysisOlder adultsPhysical exerciseAgedCognition DisordersCognitive DysfunctionHumansNetwork Meta-AnalysisRandomized Controlled Trials as TopicDementiaNeurosciencesAlzheimer's DiseaseAcquired Cognitive ImpairmentPreventionBrain DisordersNeurodegenerativeRehabilitationAgingClinical ResearchAlzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD)Clinical Trials and Supportive ActivitiesBehavioral and Social Science6 Evaluation of treatments and therapeutic interventions6.7 Physical