| Mild cognitive impairment(MCI)is regarded as the state of the transition between normal cognition and dementia.Older adults with MCI are suffering from changes in cognitive functions and are more likely to experience physical dysfunction,worse mood and poor sleep quality,which seriously affect their quality of life.Study has shown that net-step dual-task training is an easy and interesting kind of non-pharmacological intervention and can improve the cognitive and physical function of healthy older adults,as well as reduce the rate of falling.However,there is no report on the effect of net-step dual-task training in older adults with MCI.Objective:The purpose of this study is to develop a kind of dual-task training program suitable for older adults with MCI based on their functional characteristics.To evaluate the efficacy of a12-week net-step dual-task training on cognitive functions,physical functions,depression,quality of life and sleep quality in older adults with MCI.And to provide new strategies and methods for delaying the occurrence and conversion of dementia.Methods:This was a non-randomized controlled trial conducted in 56 older adults with MCI(28persons in each group)in a nursing home in Changchun,China from October 2018 to January2019.Participants in the intervention group performed the net-step dual-task program for 12 weeks,3 sessions each week(36 sessions total).Each session lasted 50 minutes.Participants in the control group maintained their usual lifestyle.The main outcomes were cognitive and physical functions.The second outcomes were depression,quality of life and sleep quality.The outcomes included cognitive performance measured by Montreal Cognitive Assessment(MoCA)and Mini-Mental State Examination(MMSE),physical functions measured by Berg Balance Scale(BBS),Timed Up and Go test(TUG),and Falls Efficacy Scale-International(FES-I),depression measured by Geriatric Depression Scale(GDS-15),quality of life measured by Short Form 12-item questionnaire(SF-12),consisting of the physical component summary(PCS)and the mental component summary(MCS)and sleep quality measured by the Pittsburgh Sleep Quality Index(PSQI)at baseline,week 6 and week 12.The analyses were conducted using IBM SPSS Statistics version 25.0 for Mac with a statistical significanceset at p-value < 0.05(2-sided).Results:1.Implementation of the intervention: A total of 2 participants in the intervention group dropped out of this study after the intervention,of which 1 with fracture caused by falling(nothing to do with this study)and 1 moving out of the nursing home.A total of 3 participants in the control group dropped out of this study after the intervention,of which 2 moving out of the nursing home and 1 with illness.2.Socio-demographic and baseline data: There were no significant differences in the results of socio-demographic data,including age,gender,marital status,educational level,pension income,homeplace,falling during the past year and chronic diseases.No significant differences were found in cognitive function,physical function,depression,quality of life and sleep quality between groups.3.Effect of net-step dual task training on cognitive and physical function of older adults with MCICompared with the control group,the scores of MMSE and MoCA in the intervention group increased significantly,and there were significant differences in the scores of MMSE and MoCA between the two groups(P < 0.001).Further comparison of the changes at every two time points showed that the score of MMSE in the intervention group were significantly higher than that in the control group from baseline to 6th week,baseline to 12 th week and 6 to12 th week(P < 0.05).The score of MoCA increased significantly from 6th week to 12 th week and baseline to 12 th week(P < 0.05).The results of intra-group comparison showed that the scores of MMSE and MoCA in the intervention group were significantly higher than those in the baseline at 6 and 12 th week(P < 0.05).Compared with the control group,the score of BBS in the intervention group increased significantly,while the scores of TUG and FES-I decreased significantly.There were significant differences in the scores of BBS,TUG and FES-I between the two groups(P <0.001).Further comparison of the changes at every two time points showed that the score of BBS in the intervention group were significantly higher than that in the control group from baseline to 6th week,baseline to 12 th week and 6 to 12 th week(P < 0.05).The score of TUG in the intervention group decreased significantly than that in the control group from baseline to 6th week and baseline to 12 th week(P < 0.05).The score of FES-I in the intervention group decreased significantly than that in the control group from baseline to 12 th week and 6to 12 th week(P < 0.05).The results of intra-group comparison showed that the score of BBS in the intervention group were significantly higher than that in the baseline at 12 th week,and the scores of TUG and FES-I in the intervention group decreased significantly than those in the baseline at 6 and 12 th week(P < 0.05).4.Effect of net-step dual task training on depression,quality of life and sleep quality of older adults with MCICompared with the control group,the scores of GDS-15 and PSQI in the intervention group decreased significantly,while the scores of PCS and MCS increased significantly.There were significant differences in the scores of GDS-15,PCS,MCS and PSQI between the two groups(P < 0.001).Further comparison of the changes at every two time points showed that the scores of GDS-15 and PSQI in the intervention group decreased significantly than those in the control group from baseline to 6th week,baseline to 12 th week and 6 to 12 th week(P < 0.05).The scores of PCS and MCS in the intervention group increased significantly than those in the control group from baseline to 6th week,baseline to 12 th week and 6 to 12 th week(P < 0.05).The results of intra-group comparison showed that the scores of GDS-15 and PSQI in the intervention group were significantly lower than those in the baseline at 6 and 12 th week,and the scores of PCS and MCS in the intervention group increased significantly than those in the baseline at 6 and 12 th week(P < 0.05).Conclusions:1.Net-step dual task training can effectively improve the cognitive function of older adults with MCI.2.Net-step dual task training can effectively improve the balance,gait performance and fall efficiency of older adults with MCI.3.Net-step dual task training can significantly improve depression,quality of life and sleep quality of older adults with MCI.4.Net-step dual-task training is a safe,effective and interesting training method,which is suitable for older adults with MCI.Participants had high compliance and there were no adverse events.It can be popularized and applied in older adults with MCI. |
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