A combined cognitive and fitness training helps restore older adults’ attention abilities to young adult levels

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A new study found promising results for a combined physical fitness and cognitive intervention designed to enhance neuroplasticity in older adults. Using a motion-capture video game, the intervention appeared to remediate age-related declines in attention. The findings were published in the journal npj Aging.

With age, cognitive abilities naturally decline. But there is some evidence that this decline can be slowed with training. For example, cognitive interventions that leverage neuroplasticity have shown potential in improving the cognitive abilities of older adults. Additionally, physical fitness interventions have been found to improve older adults’ cognitive abilities as well as their physical health. This pattern of findings suggests that an intervention that combines both cognition and fitness may offer the most cognitive benefits.

“My background is actually in Kinesiology, and I’ve always been excited to do a cognitive training study that involved exercise in a targeted fashion,” said study author Joaquin A. Anguera, the director of Neuroscape‘s Clinical Division and an associate professor at the University of California, San Francisco. “Some people want to do cognitive training while moving rather than sitting down, and that really spoke to me as a possibility for real benefits given anecdotal stories about games like ‘Dance Dance Revolution.’”

The researchers designed a randomized, placebo-controlled study to test whether the BBT intervention could improve older adults’ attention and physical fitness. First, they recruited a sample of 49 healthy older adults with an average age of 68 and randomly assigned them to one of two groups. One group (24 people) participated in the Body-Brain Trainer, an 8-week on-site intervention assisted by a trainer. The other group (25 people) was an active, expectancy-matched control group that participated in the Mind-Body Trainer, a 6-week at-home training assisted by three iOS apps.

Both groups completed a variety of physical and cognitive assessments before and after the training. These measures included a vigilance task that tested participants’ ability to stabilize their attention from moment to moment. Forty-one participants additionally participated in a one-year follow-up.

The researchers compared participants’ performance on the attention task before and after the intervention. It was found that participants in the BBT group showed significant improvements in attention which persisted at the one-year mark. These gains were not observed in the active control group. Moreover, the BBT group showed better performance than a separate cohort of young adults who completed this same attention task but without the training.

“The current results support a compensation effect,” Anguera and his team say, “given that improvements in the BBT group led to performance levels exceeding that of younger adults and suggest that integrated cognitive and physical approaches designed to augment plasticity in neural systems may have the potential to remediate certain aging deficits.”

There was also neural evidence of improved attention in the BBT group. Electroencephalography (EEG) recordings taken during the attention task revealed that those who participated in the combined training showed middle frontal theta power that was equivalent to that of young adults. This neural metric has been associated with sustained attention.

“I was excited to see that the participants showed both behavioral and neural improvements, with some of these reaching young adult levels,” Anguera told PsyPost. “Such findings need to be replicated, but the prospect is pretty neat.”

The combined intervention also improved participants’ fitness levels — the BBT group saw improvements in their balance as well as reductions in diastolic blood pressure after training. Notably, these cognitive and physical benefits emerged after a relatively short training period compared to previous studies of combined interventions. The study authors say this may be because the cognitive and physical components of the intervention were integrated within a video game rather than divided over multiple training days.

The findings suggest that “there are more than one way to get to the same outcome (in this case cognitive training), and that these types of tools are not the answer, but just another tool in one’s tool belt to try and help one’s cognitive function,” Anguera said.

Of note, the study was limited since the design did not allow researchers to assess whether the Body-Brain Trainer contributed to more positive outcomes than would an intervention focused solely on cognitive or physical training.

Anguera said that it “would be great to follow this up with a more mechanistic trial where we test this intervention against cognitive training alone as well as physical fitness training alone, to try and see if the possibility of synergistic effects exist beyond these control groups. And then to see how this might fare in other populations where attention improvements are typically sought after.”

“We were pretty excited to have an expectancy matched placebo control for this study, as the value of this type of control group is not really well appreciated,” he added. “So I would hope more groups look to use this type of control for their studies.”

The study, “Integrated cognitive and physical fitness training enhances attention abilities in older adults”, was authored by Joaquin A. Anguera, Joshua J. Volponi, Alexander J. Simon, Courtney L. Gallen, Camarin E. Rolle, Roger Anguera-Singla, Erica A. Pitsch, Christian J. Thompson, and Adam Gazzaley.

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