The quest for synergy between physical exercise and cognitive stimulation via exergaming in people with dementia: a randomized controlled trial
Abstract Background Exercise is often proposed as a non-pharmacological intervention to delay cognitive decline in people with dementia, but evidence remains inconclusive. Previous studies suggest that combining physical exercise with cognitive stimulation may be more successful in this respect. Exe...
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doaj-7461859ef18244bc8ee51fa9915ee58d2020-11-25T02:00:07ZengBMCAlzheimer’s Research & Therapy1758-91932019-01-0111111310.1186/s13195-018-0454-zThe quest for synergy between physical exercise and cognitive stimulation via exergaming in people with dementia: a randomized controlled trialEsther G. A. Karssemeijer0Justine A. Aaronson1Willem J. R. Bossers2Rogier Donders3Marcel G. M. Olde Rikkert4Roy P. C. Kessels5Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Geriatric MedicineRadboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Medical PsychologyBeweegStrateegRadboud University Medical Center, Department for Health EvidenceRadboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Geriatric MedicineRadboud University Medical Center, Radboudumc Alzheimer CenterAbstract Background Exercise is often proposed as a non-pharmacological intervention to delay cognitive decline in people with dementia, but evidence remains inconclusive. Previous studies suggest that combining physical exercise with cognitive stimulation may be more successful in this respect. Exergaming is a promising intervention in which physical exercise is combined with cognitively challenging tasks in a single session. The aim of this study was to investigate the effect of exergame training and aerobic training on cognitive functioning in older adults with dementia. Methods A three-armed randomized controlled trial (RCT) compared exergame training, aerobic training and an active control intervention consisting of relaxation and flexibility exercises. Individuals with dementia were randomized and individually trained three times a week during 12 weeks. Cognitive functioning was measured at baseline, after the 12-week intervention period and at 24-week follow-up by neuropsychological assessment. The domains of executive function, episodic memory, working memory and psychomotor speed were evaluated. Test scores were converted into standardized z-scores that were averaged per domain. Between-group differences were analysed with analysis of covariance. Results Data from 115 people with dementia (mean (SD) age = 79.2 (6.9) years; mean (SD) MMSE score = 22.9 (3.4)) were analysed. There was a significant improvement in psychomotor speed in the aerobic and exergame groups compared to the active control group (mean difference domain score (95% CI) aerobic versus control 0.370 (0.103–0.637), p = 0.007; exergame versus control 0.326 (0.081–0.571), p = 0.009). The effect size was moderate (partial η2 = 0.102). No significant differences between the intervention and control groups were found for executive functioning, episodic memory and working memory. Conclusions To our knowledge, this is the first RCT evaluating the effects of exergame training and aerobic training on cognitive functioning in people with dementia. We found that both exergame training and aerobic training improve psychomotor speed, compared to an active control group. This finding may be clinically relevant as psychomotor speed is an important predictor for functional decline. No effects were found on executive function, episodic memory and working memory. Trial registration Netherlands Trial Register, NTR5581. Registered on 7 October 2015.http://link.springer.com/article/10.1186/s13195-018-0454-zCognitionDementiaAlzheimer diseaseExercisePhysical activityCognitive stimulation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Esther G. A. Karssemeijer Justine A. Aaronson Willem J. R. Bossers Rogier Donders Marcel G. M. Olde Rikkert Roy P. C. Kessels |
spellingShingle |
Esther G. A. Karssemeijer Justine A. Aaronson Willem J. R. Bossers Rogier Donders Marcel G. M. Olde Rikkert Roy P. C. Kessels The quest for synergy between physical exercise and cognitive stimulation via exergaming in people with dementia: a randomized controlled trial Alzheimer’s Research & Therapy Cognition Dementia Alzheimer disease Exercise Physical activity Cognitive stimulation |
author_facet |
Esther G. A. Karssemeijer Justine A. Aaronson Willem J. R. Bossers Rogier Donders Marcel G. M. Olde Rikkert Roy P. C. Kessels |
author_sort |
Esther G. A. Karssemeijer |
title |
The quest for synergy between physical exercise and cognitive stimulation via exergaming in people with dementia: a randomized controlled trial |
title_short |
The quest for synergy between physical exercise and cognitive stimulation via exergaming in people with dementia: a randomized controlled trial |
title_full |
The quest for synergy between physical exercise and cognitive stimulation via exergaming in people with dementia: a randomized controlled trial |
title_fullStr |
The quest for synergy between physical exercise and cognitive stimulation via exergaming in people with dementia: a randomized controlled trial |
title_full_unstemmed |
The quest for synergy between physical exercise and cognitive stimulation via exergaming in people with dementia: a randomized controlled trial |
title_sort |
quest for synergy between physical exercise and cognitive stimulation via exergaming in people with dementia: a randomized controlled trial |
publisher |
BMC |
series |
Alzheimer’s Research & Therapy |
issn |
1758-9193 |
publishDate |
2019-01-01 |
description |
Abstract Background Exercise is often proposed as a non-pharmacological intervention to delay cognitive decline in people with dementia, but evidence remains inconclusive. Previous studies suggest that combining physical exercise with cognitive stimulation may be more successful in this respect. Exergaming is a promising intervention in which physical exercise is combined with cognitively challenging tasks in a single session. The aim of this study was to investigate the effect of exergame training and aerobic training on cognitive functioning in older adults with dementia. Methods A three-armed randomized controlled trial (RCT) compared exergame training, aerobic training and an active control intervention consisting of relaxation and flexibility exercises. Individuals with dementia were randomized and individually trained three times a week during 12 weeks. Cognitive functioning was measured at baseline, after the 12-week intervention period and at 24-week follow-up by neuropsychological assessment. The domains of executive function, episodic memory, working memory and psychomotor speed were evaluated. Test scores were converted into standardized z-scores that were averaged per domain. Between-group differences were analysed with analysis of covariance. Results Data from 115 people with dementia (mean (SD) age = 79.2 (6.9) years; mean (SD) MMSE score = 22.9 (3.4)) were analysed. There was a significant improvement in psychomotor speed in the aerobic and exergame groups compared to the active control group (mean difference domain score (95% CI) aerobic versus control 0.370 (0.103–0.637), p = 0.007; exergame versus control 0.326 (0.081–0.571), p = 0.009). The effect size was moderate (partial η2 = 0.102). No significant differences between the intervention and control groups were found for executive functioning, episodic memory and working memory. Conclusions To our knowledge, this is the first RCT evaluating the effects of exergame training and aerobic training on cognitive functioning in people with dementia. We found that both exergame training and aerobic training improve psychomotor speed, compared to an active control group. This finding may be clinically relevant as psychomotor speed is an important predictor for functional decline. No effects were found on executive function, episodic memory and working memory. Trial registration Netherlands Trial Register, NTR5581. Registered on 7 October 2015. |
topic |
Cognition Dementia Alzheimer disease Exercise Physical activity Cognitive stimulation |
url |
http://link.springer.com/article/10.1186/s13195-018-0454-z |
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