A combined cognitive and fitness training helps restore older adults’ attention abilities to young adult levels

A new study finds promising results for a combined physical fitness and cognitive intervention designed to improve neuroplasticity in older adults. Using motion capture video games, these interventions can address age-related attention decline. The findings were published in the journal npj is old.

With age, cognitive abilities naturally decline. But there is some evidence that this decline can be slowed with exercise. For example, cognitive interventions that use neuroplasticity have shown potential to improve older adults’ cognitive abilities. Additionally, physical fitness interventions have been found to improve older adults’ cognitive abilities as well as physical health. This pattern of findings suggests that interventions that combine cognition and fitness may provide the most cognitive benefits.

“My background is actually in Kinesiology, and I’m always excited to do a cognitive training study that involves exercise in a targeted way,” said study author Joaquin A. Anguera, director of the Neuroscape Clinical Division and associate professor at the University of California, San Francisco. “Some people want to do cognitive training while moving instead of sitting, and this really speaks to me as a possibility of real benefit given anecdotal stories about games like ‘Dance Dance Revolution.'”

The researchers designed a randomized, placebo-controlled study to test whether the BBT intervention could improve attention and physical fitness in older adults. First, they took a sample of 49 healthy elderly people with an average age of 68 and randomly assigned them to one of two groups. One group (24 people) participated in the Body-Brain Trainer, an 8-week on-site intervention facilitated by a trainer. The other group (25 people) was an expectancy-matched control group that participated in the Mind-Body Trainer, a 6-week home exercise assisted by three iOS apps.

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Both groups completed a variety of physical and cognitive assessments before and after exercise. These measures included a vigilance task that tested the participants’ ability to stabilize their attention from moment to moment. Forty-one participants also participated in the one-year follow-up.

The researchers compared the participants’ performance on attention tasks before and after the intervention. It was found that participants in the BBT group showed significant improvements in sustained attention at the one-year mark. These benefits were not observed in the active control group. In addition, the BBT group showed better performance than a separate group of young adults who completed the same attention task but without training.

“The current results support a compensatory effect,” said Anguera and his team, “because the improvement in the BBT group led to a level of performance beyond that of younger adults and shows that an integrated cognitive and physical approach designed to increase plasticity in the nervous system may have the potential to fixing certain aging deficits.

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There was also evidence of better neurological outcomes in the BBT group. Electroencephalography (EEG) recordings taken during the attention task showed that those who participated in the combined training showed similar central frontal theta power to young adults. This neural metric has been associated with sustained attention.

“I was excited to see that the participants showed behavioral and neurological improvements, with some reaching the level of young adulthood,” Anguera told PsyPost. “These findings need to be replicated, but the prospects are quite good.”

The combined intervention also improved participants’ fitness levels – the BBT group saw improvements in their balance as well as a reduction in diastolic blood pressure after exercise. Notably, these cognitive and physical benefits emerged after a relatively short training period compared to studies prior to the combined intervention. The study authors say this is because the cognitive and physical components of the intervention are combined in a video game rather than divided over several days of training.

The findings show that “there is more than one way to achieve the same result (in this case cognitive training), and the type of tool is not at answer, but it’s just another tool in the tool belt to try and help cognitive function,” Anguera said.

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Of note, the study was limited because the design did not allow the researchers to assess whether Mind-Body Training contributed to more positive outcomes than interventions that focused only on cognitive or physical training.

Anguera said that “it would be good to follow this up with a more mechanistic trial where we test this intervention against cognitive training alone and also physical fitness training, to try and see if the synergistic effect exists beyond the control group. Then to see how that happens in other populations that are usually sought.

“We are very happy to have a placebo control that meets our expectations for this study, because the value of this control group is not appreciated,” he said. “So I hope more groups use this type of control to study.”

The study, “Integrated cognitive and physical fitness training improves attentional abilities in older adults”, was written by Joaquin A. Anguera, Joshua J. Volponi, Alexander J. Simon, Courtney L. Gallen, Camarin E. Rolle, Roger Anguera-Singla , Erica A. Pitsch, Christian J. Thompson, and Adam Gazzaley.


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