The Effect Of A Comprehensive Training Based On Aerobic Exercise On The Cognitive And Motor Function And Quality Of Life In Older Adults With Mild Cognitive Impairment

Background:Mild cognitive impairment (MCI) is known as a transitional stage associated between normal aging and dementia. The incidence and prevalence of MCI increased. It is also associated with an increased risk of dementia. Previous studies showed that the moderate-intensity exercise is associated with a decreased risk of cognitive impairment.Objective:The aim of this study is to evaluate the effect of a comprehensive training based on aerobic exercise on the function in older adults with Mild Cognitive Impairment.Methods:This is a single-blinded randomized controlled trial. Sixty subjects with MCI were randomly assigned to receive either a moderate-intensity exercise therapy or usual care for 3 months. After 3 months, all patients received usual care. The exercise therapy was a specially designed dance routine which involved cognitive effort for patients to memorize the complex dance movements. Patients receiving exercise therapy danced together for 35 minutes each time with 3 times a week for 12 weeks under the monitoring of physical therapists. Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Wechsler Memory Scale-Revised (WMS-R), Digit Span Forward and Backwards, and Trail Making Test (TMT)-A and B, Digit Symbol Coding Subtest and Auditory Event Related Potentials P300 were used to assess the cognitive function of each patient at baseline,3 months, and 6 months follow-up. We used the Functional Activeities Questionnaire(FAQ) to assess the ability of daily living, used the Short-Form 36 item health survey questionnaire(SF-36) to assess the quality of life, the Geriatric Depression Scale(GDS) to assess the depression. All these assessment were done at baseline,3 months after intervention, and 6 months follow-up.All patients accept motor function assessment, such as the Berg Balance Scale(BBS) to assess the balance function of the participants,Rate Pressure Product(RPP), Metablic Equivalent(METs) and Max Heart Rate(HRmax) to assess aerobic fitness of each patient at baseline,3 months, and 6 months follow-up.Results:Fifty-eight participants completed the assessments (exercise group n=27, control group n=31) at 3 months after inclusion. Fifty-four participants completed the assessment (exercise group n=27, control group n=27) at 6 months follow-up. At baseline, we found no significant differences in any characteristics such as age, sex, education, MMSE and HIS between exercise group and control group. Compared with control group, most of the cognitive assessments including such as WMS-R Logical Memory,Trail Making Test B in treatment group were significantly improved after 3 months’ exercise(P<0.05). The scores of WMS-R Logical Memory, Trail Making Test A and Digit Symbol Coding Subtest and P300 latency improved significantly at 6 months compared with baseline.The quality of life(SF-36) were significantly improved at 6 months compared with baseline in exercise group. GDS was significantly improved at 3 months and 6 months in control group.The Berg Balance Scale of was significantly improved at 3 months and 6 months.Multiple regression showed that exercise therapy was associated with a greater memory improvement measured using the Wechsler WMS-R at 3 months (coefficient = 4.7,95%confidence interval (CI)= 2.2,7.2, p-value< 0.01) and 6 months (coefficient= 3.32,95% CI= 0.79,5.85, p-value=0.01), and exercise therapy was associated with the shortening of p300 latency at 3 months and the improvement of BBS at 6 months. In addition, the exercise therapy was also associated with a greater improvement in cognitive processing speed measured using the TMT-B (coefficient=-34.7,95% CI=-63.1,-6.3, p-value= 0.02) at 3 months,and exercise therapy was associated with the shortening of p300 latency at 3 months and the improvement of BBS at 6 months.Conclusion:This comprehensive training based on aerobic exercise as a moderate intensity exercise significantly improved memory and processing speed and the balance control after 3 months exercise therapy and this positive effect lasted even after the exercise therapy stopped.