Today We Talk About Activity Intervention vs Health Education in Sedentary Older Adults -, let’s Start
We wanted to examine whether a physical activity intervention could prevent cognitive decline in older adults.
Because epidemiologic data had shown, pretty consistently, that folks who reported doing more physical activity were less likely to have cognitive decline over time than people who were doing less physical activity.
Randomized controlled trial data was fairly limited, either by small sample sizes or short durations, and the results had been fairly mixed.
The primary outcome of the life study was incident mobility disability.
As a secondary outcome, life measured cognition, and that’s what this paper focused on.
We wanted to determine whether physical activity intervention would be better than a health education control at preserving cognitive function in older adults at risk of mobility disability.
We randomized just over 1600 participants who were 70 to 89 years old to either a health education control or a physical activity intervention and followed them for two years.
Our primary cognitive outcome was declining cognitive function, measured with two tests of cognition — a memory test called the Hopkins Verbal Learning Test and speed of processing and complex processing task called the Digit Symbol Coding Task.
We found that at 24 months there was no difference in cognitive function on any of our measures between the physical activity intervention and the health education control.
However, what we did notice was that nobody really declined.
Both groups maintained their cognitive function throughout the two years of the study when we would have expected at least some age-related decline.
We did find two subgroups of patients for whom the exercise intervention was better than the health education control, at least in terms of their executive function, and that was in people who started the study age 80 and older or who started with lower physical performance.
We felt it was important to remember that our health education control was actually quite stimulating cognitively and socially,
and therefore likely to have also preserved cognitive function.
And we do have evidence that neither group actually declined over two years to support that hypothesis.
Therefore, we would recommend that patients be advised to continue to stay cognitively, socially and physically active in their older years to help preserve cognitive function.
I think it would be really important to do another randomized controlled trial that focuses primarily on cognition as the primary outcome and has a very carefully selected control group that may not interfere with cognition, such as a light stretching control.
In addition, other outcomes could also be looked at.
This population in the life study, while older and frail was not already cognitively impaired.
So we still don’t know whether an exercise intervention could prevent, say, the progression from mild cognitive impairment to dementia.