Physical and cognitive training vs. physical training to promote older adults’ physical activity

What is it about?

Executive functions are a set of cognitive processes that encompass abilities such as problem-solving, attention control, working memory, and cognitive flexibility. They are essential for goal-directed behavior, effective self-regulation, and adaption to new situations. They play an important role in physical activity and overall functioning, especially in older adults. The goal of this study was to examine whether a year-long training program combining physical and cognitive training (PTCT) would have greater effects on physical activity in older adults compared to physical training (PT) alone. The study also aimed to determine if executive functions predicted physical activity levels at various time points throughout the study. We conducted a randomized controlled trial involving older adults between the ages of 70 and 85 who lived in Jyväskylä, Finland. The PT group consisted of 159 participants who received supervised resistance, walking, and balance training, along with home exercises and self-administered moderate-intensity activity. The PTCT group included 155 participants who received the same physical training as the PT group but also engaged in cognitive training specifically targeting executive functions using a computer program. The intervention lasted 12 months and the participants were thereafter followed up for 12 months and during the COVID-19. Physical activity was assessed using a single-item question on a seven-scale rating. Different aspects of executive functions were assessed using three tests: the color-word Stroop test (inhibition of automatic response and global executive functions), Trail Making Test (TMT) B-A (set-shifting and cognitive flexubility), and Letter Fluency (working memory updating). We found that there was no significant difference in physical activity levels between the PTCT and PT groups over the course of the study. However, both groups tended to increase their physical activity levels compared to baseline throughout the study period, including during the COVID-19 outbreak. Higher baseline scores on all executive functions tests predicted higher physical activity level at least at some of the subsequent measurements, but the predictive effect of the tests varied across the time points and the study groups. The Stroop test was the strongest predictor of physical activity across the study period. In conclusion, the study found that cognitive training did not provide additional benefits to physical training alone in terms of increasing physical activity levels in older adults. However, engaging in multicomponent training and having higher executive function scores at baseline may support the adoption and maintenance of a physically active lifestyle in older adults.

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Why is it important?

Executive functions training combined with physical training is a promising strategy to increase physical activity in older adults, because executive functions are important for self-regulation. However, the findings from the present study show that very specific, computerized executive functions training may not be effective when combined with exercise. The multimodal physical training program itself may have improved executive functions. Nevertheless, it is important to focus on improving executive functions in older age because people who had better executive functions at the beginning of the study reported higher physical activity throughout the entire study period.

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