Baseline Global Cognitive Function Affects Cognitive and Functional Outcomes of Combined Physical and Cognitive Training Among Older Adults With Cognitive Decline

I-Ching Chuang; Wan-Wen Liao; Ching-Yi Wu; Ting-Ting Yeh; Chia-Ling Chen; Chung-Hao Lin; Tzu-Hsin Huang; Yu-Cheng Pei

doi:10.5014/ajot.2022.042218

Baseline Global Cognitive Function Affects Cognitive and Functional Outcomes of Combined Physical and Cognitive Training Among Older Adults With Cognitive Decline

Am J Occup Ther. 2022 Mar 1;76(2):7602205140. doi: 10.5014/ajot.2022.042218.

Authors

I-Ching Chuang¹, Wan-Wen Liao², Ching-Yi Wu³, Ting-Ting Yeh⁴, Chia-Ling Chen⁵, Chung-Hao Lin⁶, Tzu-Hsin Huang⁷, Yu-Cheng Pei⁸

Affiliations

¹ I-Ching Chuang, PhD, is Assistant Professor, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan, and Assistant Research Fellow, Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
² Wan-Wen Liao, PhD, is Assistant Professor, Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan.
³ Ching-Yi Wu, ScD, OTR, is Professor and Chair, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan, and Research Fellow, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; cywu@mail.cgu.edu.tw.
⁴ Ting-Ting Yeh, PhD, is Assistant Professor, Master's Degree Program in Healthcare Industry, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁵ Chia-Ling Chen, MD, PhD, is Attending Doctor, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan, and Professor and Chair, Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁶ Chung-Hao, MD, is Attending Doctor, Department of Internal Medicine, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan, and Attending Doctor, Division of Geriatric Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
⁷ Tzu-Hsin Huang, MS, is Director, Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Chang Gung Medical Foundation, Taoyuan, Taiwan.
⁸ Yu-Cheng Pei, MD, PhD, is Professor, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, and Director, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.

PMID: 35201299
DOI: 10.5014/ajot.2022.042218

Abstract

Importance: Baseline global cognitive function may affect cognitive and functional outcomes during combined physical and cognitive training; however, how it influences the effects of combined training remains uncertain.

Objective: To determine the impact of baseline global cognitive function on cognitive and functional outcomes after combined physical and cognitive training among older adults with cognitive decline.

Design: Observational.

Setting: Local communities and senior centers.

Participants: Older adults with mild cognitive decline (MCD; n = 51) and moderate to severe cognitive decline (MSCD; n = 40).

Intervention: Participants received 45 to 55 min of physical exercise training followed by 45 to 55 min of cognitive training in one session per week for 12 wk. Outcomes and Measures: Montreal Cognitive Assessment (MoCA), Lawton-Brody Instrumental Activities of Daily Living Scale (Lawton-Brody IADL), Word Recall Test (WRT), Stroop Color and Word Test (SCWT), Digital Symbol Substitution Test (DSST), and Trail Making Test (TMT) scores were assessed and compared between the MCD and MSCD groups.

Results: Significant interaction effects were found for the WRT, SCWT, MoCA, and Lawton-Brody IADL. WRT and SCWT scores significantly improved in the MCD group, whereas MoCA and Lawton-Brody IADL scores significantly improved in the MSCD group. DSST scores increased among all participants, but TMT scores improved only in the MCD group.

Conclusions and relevance: Older adults' baseline global cognitive function affected cognitive and instrumental activities of daily living (IADL) outcomes regarding combined training. High-level cognitive function, including inhibition and shifting abilities and working memory capacity, improved among older adults with MCD, whereas general cognitive function and IADLs improved among older adults with MSCD. What This Article Adds: Findings revealed domain-specific changes with respect to baseline cognitive function, which may help to refine current combined training protocols and facilitate development of personalized combined training programs for older adults with cognitive impairments.

Publication types

Observational Study

MeSH terms

Activities of Daily Living*
Aged
Cognition
Cognitive Dysfunction* / psychology
Exercise
Humans
Trail Making Test

Abstract

Publication types

MeSH terms

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