Combined Dual-Task Gait Training and Aerobic Exercise to Improve Cognition, Mobility, and Vascular Health in Community-Dwelling Older Adults at Risk for Future Cognitive Decline ¹

Authors

Michael A. Gregory, Western University
Narlon C. Boa Sorte Silva, Lawson Health Research Institute
Dawn P. Gill, Western University
Cheri L. McGowan, Lawson Health Research Institute
Teresa Liu-Ambrose, The University of British Columbia
J. Kevin Shoemaker, Western University
Vladimir Hachinski, Western University
Jeff Holmes, Western University
Robert J. Petrella, Western University

Document Type

Article

Publication Date

1-1-2017

Journal

Journal of Alzheimer's Disease

Volume

57

Issue

3

First Page

747

Last Page

763

URL with Digital Object Identifier

10.3233/JAD-161240

Abstract

© 2017 IOS Press and the authors. All rights reserved. This 6-month experimental case series study investigated the effects of a dual-task gait training and aerobic exercise intervention on cognition, mobility, and cardiovascular health in community-dwelling older adults without dementia. Participants exercised 40min/day, 3 days/week for 26 weeks on a Biodex GaitTrainer2 treadmill. Participants were assessed at baseline (V0), interim (V1: 12-weeks), intervention endpoint (V2: 26-weeks), and study endpoint (V3: 52-weeks). The study outcomes included: Cognition [executive function (EF), processing speed, verbal fluency, and memory]; mobility: Usual & dual-task gait (speed, step length, and stride time variability); and vascular health: Ambulatory blood pressure, carotid arterial compliance, and intima-media thickness (cIMT). Fifty-six participants [age: 70(6) years; 61% female] were included in this study. Significant improvements following the exercise program (V2) were observed in cognition: EF (p=0.002), processing speed (p <0.001), verbal fluency [digit symbol coding (p <0.001), phonemic verbal fluency (p <0.001)], and memory [immediate recall (p <0.001) and delayed recall (p <0.001)]; mobility: Usual & dual-task gait speed (p=0.002 and p <0.001, respectively) and step length (p=0.001 and p = 0.003, respectively); and vascular health: CIMT (p=0.002). No changes were seen in the remaining outcomes. In conclusion, 26 weeks of dual-task gait training and aerobic exercise improved performance on a number of cognitive outcomes, while increasing usual & dual-task gait speed and step length in a sample of older adults without dementia.