The Mental Activity and eXercise (MAX) trial: Effects on physical function and quality of life among older adults with cognitive complaints

Laura E Middleton; Maria I Ventura; Wendy Santos-Modesitt; Gina Poelke; Kristine Yaffe; Deborah E Barnes

doi:10.1016/j.cct.2017.10.009

The Mental Activity and eXercise (MAX) trial: Effects on physical function and quality of life among older adults with cognitive complaints

Contemp Clin Trials. 2018 Jan:64:161-166. doi: 10.1016/j.cct.2017.10.009. Epub 2017 Oct 21.

Authors

Laura E Middleton¹, Maria I Ventura², Wendy Santos-Modesitt³, Gina Poelke⁴, Kristine Yaffe⁵, Deborah E Barnes⁶

Affiliations

¹ Department of Kinesiology, University of Waterloo, Canada. Electronic address: Laura.middleton@uwaterloo.ca.
² Department of Epidemiology and Biostatistics, University of California San Francisco, USA.
³ Benioff Children's Hospital, University of California San Francisco, USA.
⁴ Department of Clinical Psychology, Notre Dame de Namur University, USA.
⁵ Department of Psychiatry, University of California San Francisco, USA; Department of Psychiatry, San Francisco Veterans Affairs Medical Centre, USA; Department of Medicine, University of California San Francisco, USA; Department of Neurology, University of California San Francisco, USA.
⁶ Department of Psychiatry, University of California San Francisco, USA; Department of Psychiatry, San Francisco Veterans Affairs Medical Centre, USA. Electronic address: Deborah.barnes@ucsf.edu.

Abstract

Background: Older adults with cognitive complaints are vulnerable to dementia, physical impairments, and poor quality of life. Exercise and mental activity may improve physical function and health-related quality of life (HRQOL) but combinations have not been investigated systematically. The Mental Activity and eXercise (MAX) trial found that mental activity plus exercise over 12weeks improved cognitive function (primary outcome) in sedentary older adults with cognitive complaints.

Objective: To investigate the effects of combinations of two mental activity and exercise programs on physical function and HRQOL (secondary outcomes).

Methods: Participants (n=126, age 73±6years, 65% women) were randomized to 12weeks of exercise (aerobic exercise or stretching/toning, 3×60min/week) plus mental activity (computer-based cognitive training or educational DVDs, 3×60min/week) using a factorial design. Assessments included the Senior Fitness Test (physical function), Short Form-12 physical and mental sub-scales (HRQOL), and CHAMPS questionnaire (physical activity).

Results: There were no differences between groups at baseline (p>0.05). We observed improvements over time in most physical function measures [chair stands (p-for-time=0.001), arm curls (p-for-time<0.001), step test (p-for-time=0.003), sit & reach (p-for-time=0.01), and back scratch (p-for-time=0.04)] and in physical HRQOL (p-for-time=0.04). There were no differences in change between groups (group∗time p>0.05). Changes in most physical function measures and physical HRQOL correlated with physical activity changes.

Conclusion: Combined mental activity and exercise interventions of various types can improve both physical function and physical HRQOL among sedentary older adults with cognitive complaints. Exercise control group design should be carefully considered as even light exercise may induce benefits in vulnerable older adults.

Keywords: Cognitive training; Exercise; Older adults; Physical function; Quality of life; Randomized controlled trial.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Cognition*
Dementia
Exercise*
Female
Health Status*
Humans
Male
Mental Health*
Patient Compliance
Quality of Life

Abstract

Publication types

MeSH terms

Grants and funding