A comparison of physical exercise and cognitive training interventions to improve determinants of functional mobility in healthy older adults.
OBJECTIVES
Mobility is a complex but crucial clinical outcome in older adults. Past observational studies have highlighted that cardiorespiratory fitness (CRF), energy cost of walking (ECW), and cognitive switching abilities are associated with mobility performance, making these key determinants of mobility intervention targets to enhance mobility in older adults. The objective of this study was to compare, in the same design, the impact of three training methods - each known to improve either CRF, ECW, or cognitive switching abilities - on mobility in healthy older adults.


METHODS
Seventy-eight participants (69.28 ± 4.85yo) were randomly assigned to one of three twelve-week interventions: Aerobic Exercise (AE; n = 26), Gross Motor Abilities (GMA; n = 27), or Cognitive (COG; n = 25) training. Each intervention was designed to improve one of the three key determinants of mobility (CRF, ECW, and cognitive switching). Primary outcomes (usual gait speed, and TUG performance) and the three mobility determinants were measured before and after the intervention.


RESULTS
Repeated-measures ANOVAs showed a time effect for TUG performance (F(1,75) = 14.92, p < .001): all groups equally improved after the intervention (ΔTUGpost-pre, in seconds, with 95% CI: AE = -0.44 [-0.81 to -0.08]; GMA = -0.60 [-1.10 to -0.10]; COG = -0.33 [-0.71 to 0.05]). No significant between group differences were observed. CRF was improved in the AE group only (Hedges' G = 0.27, small effect), ECW and cognitive switching improved the most in the GMA (Hedges' G = -0.78, moderate effect) and COG groups (Hedges' G = -1.93, large effect) respectively. Smaller improvements in ECW were observed following AE and COG trainings (Hedges' G: AE = -0.39, COG = -0.36, both small effects) as well as in cognitive switching following AE and GMA training (Hedges' G: AE = -0.42, GMA = -0.21, both small effects).


DISCUSSION
This study provides further support to the notion that multiple interventional approaches (aerobic, gross motor exercise, or cognitive training) can be employed to improve functional mobility in older adults, giving them, and professionals, more options to promote healthy ageing.
['Pothier|Kristell|K|', 'Vrinceanu|Tudor|T|', 'Intzandt|Brittany|B|', 'Bosquet|Laurent|L|', 'Karelis|Antony D|AD|', 'Lussier|Maxime|M|', 'Vu|T T Minh|TTM|', 'Nigam|Anil|A|', 'Li|Karen Z H|KZH|', 'Berryman|Nicolas|N|', 'Bherer|Louis|L|']
D000368:Aged D003071:Cognition D015444:Exercise D005081:Exercise Therapy D006801:Humans D016138:Walking D000072797:Walking Speed
Cognitive switching abilities Gross motor abilities Aerobic training Computerized cognitive training Timed-up and go test