Maria A Fiatarone Singh1, Nicola Gates2, Nidhi Saigal3, Guy C Wilson3, Jacinda Meiklejohn3, Henry Brodaty4, Wei Wen5, Nalin Singh6, Bernhard T Baune7, Chao Suo8, Michael K Baker9, Nasim Foroughi10, Yi Wang11, Perminder S Sachdev5, Michael Valenzuela12. 1. Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, Sydney Medical School, The University of Sydney, Lidcombe, New South Wales, Australia; Hebrew SeniorLife, Boston, MA; Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Electronic address: maria.fiataronesingh@sydney.edu.au. 2. Private Neuropsychology Practice, Mosman, New South Wales, Australia. 3. Exercise Health and Performance, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia. 4. School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia. 5. School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Center for Healthy Brain Ageing (CHeBA), NPI, Euroa Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia. 6. Royal Prince Alfred and Balmain Hospital Balmain Hospital, Balmain, New South Wales, Australia; Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia. 7. Department of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia. 8. Monash Clinical and Imaging Neuroscience, School of Psychology and Psychiatry, Monash University, Clayton, Victoria, Australia. 9. Exercise Health and Performance, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia; Australian Catholic University, New South Wales, Australia. 10. Clinical and Rehabilitation Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia. 11. Department of Medicine and the Diabetes Center, University of California at San Francisco, San Francisco, CA. 12. Regenerative Neuroscience Group, Brain and Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia.
Abstract
BACKGROUND:Mild cognitive impairment (MCI) increases dementia risk with no pharmacologic treatment available. METHODS: The Study of Mental and Resistance Training was a randomized, double-blind, double-sham controlled trial of adults with MCI. Participants were randomized to 2 supervised interventions: active or sham physical training (high intensity progressive resistance training vs seated calisthenics) plus active or sham cognitive training (computerized, multidomain cognitive training vs watching videos/quizzes), 2-3 days/week for 6 months with 18-month follow-up. Primary outcomes were global cognitive function (Alzheimer's Disease Assessment Scale-cognitive subscale; ADAS-Cog) and functional independence (Bayer Activities of Daily Living). Secondary outcomes included executive function, memory, and speed/attention tests, and cognitive domain scores. RESULTS:One hundred adults with MCI [70.1 (6.7) years; 68% women] were enrolled and analyzed. Resistance training significantly improved the primary outcome ADAS-Cog; [relative effect size (95% confidence interval) -0.33 (-0.73, 0.06); P < .05] at 6 months and executive function (Wechsler Adult Intelligence Scale Matrices; P = .016) across 18 months. Normal ADAS-Cog scores occurred in 48% (24/49) after resistance training vs 27% (14/51) without resistance training [P < .03; odds ratio (95% confidence interval) 3.50 (1.18, 10.48)]. Cognitive training only attenuated decline in Memory Domain at 6 months (P < .02). Resistance training 18-month benefit was 74% higher (P = .02) for Executive Domain compared with combined training [z-score change = 0.42 (0.22, 0.63) resistance training vs 0.11 (-0.60, 0.28) combined] and 48% higher (P < .04) for Global Domain [z-score change = .0.45 (0.29, 0.61) resistance training vs 0.23 (0.10, 0.36) combined]. CONCLUSIONS:Resistance training significantly improved global cognitive function, with maintenance of executive and global benefits over 18 months.
RCT Entities:
BACKGROUND: Mild cognitive impairment (MCI) increases dementia risk with no pharmacologic treatment available. METHODS: The Study of Mental and Resistance Training was a randomized, double-blind, double-sham controlled trial of adults with MCI. Participants were randomized to 2 supervised interventions: active or sham physical training (high intensity progressive resistance training vs seated calisthenics) plus active or sham cognitive training (computerized, multidomain cognitive training vs watching videos/quizzes), 2-3 days/week for 6 months with 18-month follow-up. Primary outcomes were global cognitive function (Alzheimer's Disease Assessment Scale-cognitive subscale; ADAS-Cog) and functional independence (Bayer Activities of Daily Living). Secondary outcomes included executive function, memory, and speed/attention tests, and cognitive domain scores. RESULTS: One hundred adults with MCI [70.1 (6.7) years; 68% women] were enrolled and analyzed. Resistance training significantly improved the primary outcome ADAS-Cog; [relative effect size (95% confidence interval) -0.33 (-0.73, 0.06); P < .05] at 6 months and executive function (Wechsler Adult Intelligence Scale Matrices; P = .016) across 18 months. Normal ADAS-Cog scores occurred in 48% (24/49) after resistance training vs 27% (14/51) without resistance training [P < .03; odds ratio (95% confidence interval) 3.50 (1.18, 10.48)]. Cognitive training only attenuated decline in Memory Domain at 6 months (P < .02). Resistance training 18-month benefit was 74% higher (P = .02) for Executive Domain compared with combined training [z-score change = 0.42 (0.22, 0.63) resistance training vs 0.11 (-0.60, 0.28) combined] and 48% higher (P < .04) for Global Domain [z-score change = .0.45 (0.29, 0.61) resistance training vs 0.23 (0.10, 0.36) combined]. CONCLUSIONS: Resistance training significantly improved global cognitive function, with maintenance of executive and global benefits over 18 months.
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