Feasibility and exploratory cognitive outcomes of three exercise modalities in oldest-old adults in assisted living facilities: A 24-week pilot randomized controlled trial.
Cognitive decline is common among the oldest-old, particularly in assisted living facilities (ALFs). This pilot randomized controlled trial examined the effects of aerobic, resistance, and mind-body exercises on cognition in ALF residents aged ≥80 years, and the feasibility and safety of exercise programs.
In a 24-week four-arm trial in one Shanghai ALF, 76 participants (aged 86.8 ± 4.1; 72.4% female) were randomized to aerobic, resistance, mind-body (simplified Tai Chi), or non-exercise control groups. Thirty-minute exercise sessions were delivered three times weekly for 24 weeks. Cognition was assessed at baseline, Week 12, and Week 24 using the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Immediate Story Recall (ISR), Boston Naming Test (BNT), Trail Making Test-A (TMT-A), and Trail Making Test-B (TMTB). Data were analyzed using intention-to-treat baseline-adjusted linear mixed-effects models with Holm-adjusted pairwise contrasts.
Recruitment was 65.5%; mean exercise attendance was 90.1%, and no intervention-related serious adverse events occurred. At week 24, aerobic and mind-body groups showed higher MMSE scores than control (aerobic-control Δ = 3.45, 0.92 to 5.99, pHolm = 0.0481; mind-body-control Δ = 3.29, 0.81 to 5.77, pHolm = 0.0492). Mind-body exercise showed higher ISR scores than control (ISR Δ = 9.84, 3.22 to 16.46, pHolm = 0.0234), whereas aerobic exercise showed better TMT-B performance than control (TMT-B Δ = -25.66 s, -41.95 to -9.37, pHolm = 0.0137). MoCA, BNT, and TMT-A differences were not significant after multiple-comparison correction.
These exercise programs were feasible and safe in ALF residents aged ≥80. Aerobic and mind-body exercise improved specific cognitive outcomes, while larger trials are needed to confirm these findings.
This study was registered on Chinese Clinical Trail Registry (ChiCTR2500111703).
In a 24-week four-arm trial in one Shanghai ALF, 76 participants (aged 86.8 ± 4.1; 72.4% female) were randomized to aerobic, resistance, mind-body (simplified Tai Chi), or non-exercise control groups. Thirty-minute exercise sessions were delivered three times weekly for 24 weeks. Cognition was assessed at baseline, Week 12, and Week 24 using the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Immediate Story Recall (ISR), Boston Naming Test (BNT), Trail Making Test-A (TMT-A), and Trail Making Test-B (TMTB). Data were analyzed using intention-to-treat baseline-adjusted linear mixed-effects models with Holm-adjusted pairwise contrasts.
Recruitment was 65.5%; mean exercise attendance was 90.1%, and no intervention-related serious adverse events occurred. At week 24, aerobic and mind-body groups showed higher MMSE scores than control (aerobic-control Δ = 3.45, 0.92 to 5.99, pHolm = 0.0481; mind-body-control Δ = 3.29, 0.81 to 5.77, pHolm = 0.0492). Mind-body exercise showed higher ISR scores than control (ISR Δ = 9.84, 3.22 to 16.46, pHolm = 0.0234), whereas aerobic exercise showed better TMT-B performance than control (TMT-B Δ = -25.66 s, -41.95 to -9.37, pHolm = 0.0137). MoCA, BNT, and TMT-A differences were not significant after multiple-comparison correction.
These exercise programs were feasible and safe in ALF residents aged ≥80. Aerobic and mind-body exercise improved specific cognitive outcomes, while larger trials are needed to confirm these findings.
This study was registered on Chinese Clinical Trail Registry (ChiCTR2500111703).
Authors
Tao Tao, Wang Wang, Zhang Zhang, Yu Yu, Heath Heath, Tari Tari, Taylor Taylor, Kramer Kramer, Erickson Erickson, Ligeza Ligeza, Paas Paas, Teo Teo, Falck Falck, Liu-Ambrose Liu-Ambrose, Herold Herold, Zou Zou
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