Otago Exercise Program Plus Cognitive Dual-task can Reduce Fall Risk, Improve Cognition and Functioning in Older Adults

Abstract

Background: The risk of falling increases with neuromusculoskeletal and cognitive changes resulting from aging. Physical exercise shows beneficial effects on the risk of falling, but the results are unknown when associated with cognitive activity dual-task (DT).

Objective: The objective of the study was to evaluate the impacts of the Otago Exercise Program (OEP) plus DT cognitive activity on the risk of falling in older adults.

Methods: 36 older adults (83.5 ± 5.7 years) participated in a quasi-experimental study, distributed in two experimental groups and a control group: 1) OEP (OEPG; n=12), 2) OEP plus DT (OEPDTG; n = 12), and a control group (CG; n=12). Older adults were evaluated at pre- and post- 12 weeks of intervention. The thresholds for the risk of falling were considered as multiparameter scores of the 10 Meter Walking Test (10MWT), evocative 10MWT, Timed Up and Go (TUG), Sit to Stand Test (STS), and The Four-Stage Balance Test (Four-Stage), and the Montreal Cognitive Assessment (MoCA), to test the cognitive impairment.

Results: At baseline, all groups were homogeneous. Post-intervention, the experimental groups presented significant functional differences, in comparison to the CG, for 10MWT (OEPDTG: p= 0.002; OEPG: p= 0.002); evocative 10MWT (OEPDTG: p=0.001; OEPG: p=0.001); TUG (OEPDTG: p=0.034); STS (OEPDTG: p<0.001; OEPG: p<0.001) and cognitive for MoCA (OEPDTG: p<0.019). Significant intra-group differences (pre-post) were observed in all intervention groups, but none in CG. The risk of falling (Four-Stage) in experimental groups (OEPDTG: 33.3%; OEPG: 41.7%) was considerably lower than CG (83.3%).

Conclusion: Otago Exercise Program alone can reduce the risk of falling due to improved functionality, but adding the dual task also improves cognitive capacity in older adults. The clinical significance of these interventions goes beyond statistics.

Keywords: Physical exercise; aging; cognitive; double task; elderly; physical activity.