The Effects of Exergame Telerehabilitation in Persons With Subjective Cognitive Decline.

BACKGROUND AND OBJECTIVES: The primary aim of this Stage IB randomized controlled trial (RCT) was to test the preliminary effects of a dual-task exergaming telerehabilitation intervention on cognition and aerobic fitness, compared to aerobic exercise (AEx) only and attention control (stretching) in older adults with subjective cognitive decline. RESEARCH DESIGN AND METHODS: This RCT randomized 39 participants on a 2:1:1 allocation ratio to supervised exergame (n = 20), AEx (n = 11), and stretching (n = 8) for 12 weeks. The dual-task exergaming was concurrent moderate-intensity cycling and BrainFitRx cognitive telerehabilitation. Cognition was assessed by NIH Toolbox Cognitive Battery and aerobic fitness by 6-minute walk test (6MWT) and shuttle walk test. RESULTS: The participants were 74.6 (7.4) years old and 69% were female. The effect of time was significant, F(1, 23.9) = 13.16, p = .001, for the Fluid Composite score, and significant within-group changes were seen for the exergame group, t(14.08) = 2.53, p = .024, d = 0.33. Between-group changes did not reach significant levels for any cognitive test. Between-group changes for the 6MWT were not significant. DISCUSSION AND IMPLICATIONS: The exergame participants further improved their fluid cognition, whereas the AEx and stretching groups did not, indicating a potential synergistic effect from AEx and cognitive training. The aerobic fitness changes were similar between the exergame and AEx-only groups, indicating that the feasibility of adding cognitive training to AEx concurrently without sacrificing gains in aerobic fitness from AEx. This study shows the flexibility of exergame delivery and its potentially therapeutic effects in persons at risk for Alzheimer's dementia. CLINICAL TRIAL REGISTRATION NUMBER: NCT04311736.

Relations Between Cardiorespiratory Fitness and Cognition in Older Adults With Amnestic Mild Cognitive Impairment From the Aerobic Exercise and Cognitive Training (ACT) Trial: Sex Differences.

Objective: To examine the associations of cardiorespiratory fitness with executive function, episodic memory, and global cognition and sex differences in these associations in community-dwelling older adults with amnestic mild cognitive impairment. Design: A cross-sectional study using baseline data from the aerobic exercise and cognitive training (ACT) trial. Setting: The ACT trial conducted exercise testing in an exercise laboratory and data collections in a research facility. Participants: ACT trial participants were recruited through referrals, registries, exhibits, flyers, media, and advertisements and screened for eligibility. To be eligible for this study, ACT enrollees needed complete data on all study variables. Among 146 ACT enrollees, 142 met eligibility for this study (N=142). Interventions: None. Main Outcome Measures: Cardiorespiratory fitness was measured as peak oxygen consumption (Vo2peak) with a peak cycle-ergometer test, executive function with the EXAMINER, episodic memory with the Brief Visuospatial Memory Test-Revised, and global cognition with Montreal Cognitive Assessment. Results: The average age of the sample was 73.8±5.8 years with 16.9±2.9 years of education, with 87.3% White, 51.4% men, and 69.7% married. After controlling for covariates, Vo2peak was significantly related to executive function (b=.037, standard error [SE]=0.015, P=.0154, semipartial [sr] correlation coefficient=.239) and episodic memory (b=.590, SE=0.226, P=.0102, sr=.216), but not global cognition (b=.074, SE=0.055, P=.1837, sr=.125). For men, Vo2peak was significantly associated with executive function (b=.063, SE=0.024, P=.0099, r=.430) and episodic memory (b=1.088, SE=0.312, P=.0009, r=.382). Conclusions: Our findings show that Vo2peak was associated with executive function and episodic memory in the overall sample and in men. Future studies can examine the longitudinal relations between cardiorespiratory fitness and cognition.