Publication bias in research synthesis: sensitivity analysis using a priori weight functions. Aerobic Exercise Intervention, Cognitive Performance, and Brain Structure: Results from the Physical Influences on Brain in Aging (PHIBRA) Study Changes in brain volume and cognition in a randomized trial of exercise and social interaction in a community-based sample of non-demented Chinese elders. A social model for health promotion for an aging population: Initial evidence on the experience corps model Creatine Supplementation Associated or Not with Strength Training upon Emotional and Cognitive Measures in Older Women: A Randomized Double-Blind Study Individualized Piano Instruction enhances executive functioning and working memory in older adults Exercise, Fitness, and Neurocognitive Function in Older Adults: The “Selective Improvement” and “Cardiovascular Fitness” Hypotheses Cognitive Benefits of Online Social Networking for Healthy Older Adults Brain Training Game Improves Executive Functions and Processing Speed in the Elderly: A Randomized Controlled Trial A Tablet for Healthy Ageing: The Effect of a Tablet Computer Training Intervention on Cognitive Abilities in Older Adults Effects of Physical Activity Intervention on Physical and Cognitive Function in Sedentary Adults With and Without Diabetes Resistance training and executive functions: a 12-month randomized controlled trial. Twelve-week physical and leisure activity programme improved cognitive function in community-dwelling elderly subjects: a randomized controlled trial. The effects of multimodal exercise on cognitive and physical functioning and brain-derived neurotrophic factor in older women: a randomised controlled trial. The effect of cognitive-motor dual-task training on cognitive function and plasma amyloid β peptide 42/40 ratio in healthy elderly persons: a randomized controlled trial Effects of combined physical and cognitive training on fitness and neuropsychological outcomes in healthy older adults Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life. The Effect of Three Months of Aerobic Training on Stroop Performance in Older Adults Effects of group exercise on cognitive functioning and mood in older women The impact of resistance exercise on the cognitive function of the elderly. Donepezil in patients with subcortical vascular cognitive impairment: a randomised double-blind trial in CADASIL Effects of Moderate Aerobic Exercise on Cognitive Abilities and Redox State Biomarkers in Older Adults Dose-Response of Aerobic Exercise on Cognition: A Community-Based, Pilot Randomized Controlled Trial A Brain-Computer Interface Based Cognitive Training System for Healthy Elderly: A Randomized Control Pilot Study for Usability and Preliminary Efficacy Effects of Physical-Cognitive Dual Task Training on Executive Function and Gait Performance in Older Adults: A Randomized Controlled Trial Benefits of physical exercise training on cognition and quality of life in frail older adults. Complex mental and physical activity in older women and cognitive performance: a 6-month randomized controlled trial. Adaptations of Prefrontal Brain Activity, Executive Functions, and Gait in Healthy Elderly Following Exergame and Balance Training: A Randomized-Controlled Study A 12-Week Physical and Cognitive Exercise Program Can Improve Cognitive Function and Neural Efficiency in Community-Dwelling Older Adults: A Randomized Controlled Trial. A randomized controlled trial of Tai chi for balance, sleep quality and cognitive performance in elderly Vietnamese Tai chi improves cognitive and physical function in the elderly: a randomized controlled trial No Overt Effects of a 6-Week Exergame Training on Sensorimotor and Cognitive Function in Older Adults. A Preliminary Investigation The Healthy Mind, Healthy Mobility Trial: A Novel Exercise Program for Older Adults. The effects of drumming on working memory in older adults Social Dancing and Incidence of Falls in Older Adults: A Cluster Randomised Controlled Trial Effects of Tai Chi and Western exercise on physical and cognitive functioning in healthy community-dwelling older adults. Effects of computer training and internet usage on cognitive abilities in older adults: a randomized controlled study Cognitive tests that best discriminate between presymptomatic AD and those who remain nondemented Reading and solving arithmetic problems improves cognitive functions of normal aged people: a randomized controlled study The Mental Activity and eXercise (MAX) trial: a randomized controlled trial to enhance cognitive function in older adults. Long-Term Effects of Resistance Exercise Training on Cognition and Brain Volume in Older Women: Results from a Randomized Controlled Trial. Effects of Video Game Training on Measures of Selective Attention and Working Memory in Older Adults: Results from a Randomized Controlled Trial Trail Making Test errors in normal aging, mild cognitive impairment, and dementia. Exploring the effects of an "everyday" activity program on executive function and memory in older adults: Experience Corps. Changes in cognitive function in a randomized trial of physical activity: results of the lifestyle interventions and independence for elders pilot study. Randomized clinical trial of yoga-based intervention in residents from elderly homes: Effects on cognitive function
Publication bias , sometimes known as the " file-drawer problem " or " funnel-plot asymmetry , " is common in empirical research . The authors review the implication s of publication bias for quantitative research synthesis ( meta- analysis ) and describe existing techniques for detecting and correcting it . A new approach is proposed that is suitable for application to meta-analytic data sets that are too small for the application of existing methods . The model estimates parameters relevant to fixed-effects , mixed-effects or r and om-effects meta- analysis contingent on a hypothetical pattern of bias that is fixed independently of the data . The authors illustrate this approach for sensitivity analysis using 3 data sets adapted from a commonly cited reference work on research synthesis ( H. M. Cooper & L. V. Hedges , 1994 ) Studies have shown that aerobic exercise has the potential to improve cognition and reduce brain atrophy in older adults . However , the literature is equivocal with regards to the specificity or generality of these effects . To this end , we report results on cognitive function and brain structure from a 6-month training intervention with 60 sedentary adults ( 64–78 years ) r and omized to either aerobic training or stretching and toning control training .  Cognitive functions were assessed with a neuropsychological test battery in which cognitive constructs were measured using several different tests . Freesurfer was used to estimate cortical thickness in frontal regions and hippocampus volume . Results showed that aerobic exercisers , compared to controls , exhibited a broad , rather than specific , improvement in cognition as indexed by a higher “ Cognitive score , ” a composite including episodic memory , processing speed , updating , and executive function tasks ( p = 0.01 ) . There were no group differences in cortical thickness , but additional analyses revealed that aerobic fitness at baseline was specifically related to larger thickness in dorsolateral prefrontal cortex ( dlPFC ) , and hippocampus volume was positively associated with increased aerobic fitness over time . Moreover , “ Cognitive score ” was related to dlPFC thickness at baseline , but changes in “ Cognitive score ” and dlPFC thickness were associated over time in the aerobic group only . However , aerobic fitness did not predict dlPFC change , despite the improvement in “ Cognitive score ” in aerobic exercisers . Our interpretation of these observations is that potential exercise-induced changes in thickness are slow , and may be undetectable within 6-months , in contrast to change in hippocampus volume which in fact was predicted by the change in aerobic fitness . To conclude , our results add to a growing literature suggesting that aerobic exercise has a broad influence on cognitive functioning , which may aid in explaining why studies focusing on a narrower range of functions have sometimes reported mixed results Physical exercise has been shown to increase brain volume and improve cognition in r and omized trials of non-demented elderly . Although greater social engagement was found to reduce dementia risk in observational studies , r and omized trials of social interventions have not been reported . A representative sample of 120 elderly from Shanghai , China was r and omized to four groups ( Tai Chi , Walking , Social Interaction , No Intervention ) for 40 weeks . Two MRIs were obtained , one before the intervention period , the other after . A neuropsychological battery was administered at baseline , 20 weeks , and 40 weeks . Comparison of changes in brain volumes in intervention groups with the No Intervention group were assessed by t-tests . Time-intervention group interactions for neuropsychological measures were evaluated with repeated- measures mixed models . Compared to the No Intervention group , significant increases in brain volume were seen in the Tai Chi and Social Intervention groups ( p < 0.05 ) . Improvements also were observed in several neuropsychological measures in the Tai Chi group , including the Mattis Dementia Rating Scale score ( p = 0.004 ) , the Trailmaking Test A ( p = 0.002 ) and B ( p = 0.0002 ) , the Auditory Verbal Learning Test ( p = 0.009 ) , and verbal fluency for animals ( p = 0.01 ) . The Social Interaction group showed improvement on some , but fewer neuropsychological indices . No differences were observed between the Walking and No Intervention groups . The findings differ from previous clinical trials in showing increases in brain volume and improvements in cognition with a largely non-aerobic exercise ( Tai Chi ) . In addition , intellectual stimulation through social interaction was associated with increases in brain volume as well as with some cognitive improvements This report evaluates whether a program for older volunteers  , design ed for both benerativity and health promotion , leads to short-term improvements inmultiple behavioral risk factors and positive effects on intermediary risk factors for disability and other morbidities . The Experience Corps ® places  older volunteers  in public elementary schools in roles design ed to meet schools ’ needs and increase the social , physical , and cognitive activity of the volunteers . This article reports on a pilot r and omized trial in Baltimore , Maryl and . The 128 volunteers were 60–86 years old ; 95 % were African American . At follow-up of 4–8 months , physical activity , strength , people one could turn to for help , and cognitive activity increased significantly , and walking speed decreased significantly less , in participants compared to controls . In this pilot trial , physical , cognitive , and social activity increased , suggesting the potential for the Experience Corps to improve health for an aging population and simultaneously improve educational outcomes for children Purpose To assess the effects of creatine supplementation , associated or not with strength training , upon emotional and cognitive measures in older woman . Methods This is a 24-week , parallel-group , double-blind , r and omized , placebo-controlled trial . The individuals were r and omly allocated into one of the following groups ( n=14 each ) : 1 ) placebo , 2 ) creatine supplementation , 3 ) placebo associated with strength training or 4 ) creatine supplementation associated with strength training . According to their allocation , the participants were given creatine ( 4 x 5 g/d for 5 days followed by 5 g/d ) or placebo ( dextrose at the same dosage ) and were strength trained or not .  Cognitive function , assessed by a comprehensive battery of tests involving memory , selective attention , and inhibitory control , and emotional measures , assessed by the Geriatric Depression Scale , were evaluated at baseline , after 12 and 24 weeks of the intervention . Muscle strength and food intake were evaluated at baseline and after 24 weeks . Results After the 24-week intervention , both training groups ( ingesting creatine supplementation and placebo ) had significant reductions on the Geriatric Depression Scale scores when compared with the non-trained placebo group ( p = 0.001 and p = 0.01 , respectively ) and the non-trained creatine group ( p < 0.001 for both comparison ) . However , no significant differences were observed between the non-trained placebo and creatine ( p = 0.60 ) groups , or between the trained placebo and creatine groups ( p = 0.83 ) . Both trained groups , irrespective of creatine supplementation , had better muscle strength performance than the non-trained groups . Neither strength training nor creatine supplementation altered any parameter of cognitive performance . Food intake remained unchanged . Conclusion Creatine supplementation did not promote any significant change in cognitive function and emotional parameters in apparently healthy older individuals . In addition , strength training per se improved emotional state and muscle strength , but not cognition , with no additive effects of creatine supplementation . Trial Registration Clinical trials.gov This study evaluates transfer from domain-specific , sensorimotor training to cognitive abilities associated with executive function . We examined Individualized Piano Instruction ( IPI ) as a potential cognitive intervention to mitigate normal age-related cognitive decline in older adults . Thirty-one musically naïve community-dwelling older adults ( ages 60–85 ) were r and omly assigned to either the experimental group ( n = 16 ) or control group ( n = 15 ) . Neuropsychological assessment  s were administered at three time points : pre-training , following six months of intervention , and following a three-month delay . The experimental group significantly improved performance on the Trail Making Test and Digit Symbol measures as compared to healthy controls . Results of this study suggest that IPI may serve as an effective cognitive intervention for age-related cognitive decline Background Although basic research has uncovered biological mechanisms by which exercise could maintain and enhance adult brain health , experimental human studies with older adults have produced equivocal results . Purpose This r and omized clinical trial aim ed to investigate the hypotheses that ( a ) the effects of exercise training on the performance of neurocognitive tasks in older adults is selective , influencing mainly tasks with a substantial executive control component and ( b ) performance in neurocognitive tasks is related to cardiorespiratory fitness . Methods Fifty-seven older adults ( 65–79 years ) participated in aerobic or strength- and -flexibility exercise training for 10 months . Neurocognitive tasks were selected to reflect a range from little ( e.g. , simple reaction time ) to substantial ( i.e. , Stroop Word – Color conflict ) executive control . Results Performance in tasks requiring little executive control was unaffected by participating in aerobic exercise .  Improvements in Stroop Word – Color task performance were found only for the aerobic exercise group . Changes in aerobic fitness were unrelated to changes in neurocognitive function . Conclusions Aerobic exercise in older adults can have a beneficial effect on the performance of speeded tasks that rely heavily on executive control . Improvements in aerobic fitness do not appear to be a prerequisite for this beneficial effect Objectives Research suggests that older adults who remain socially active and cognitively engaged have better cognitive function than those who are isolated and disengaged . This study examined the efficacy of learning and using an online social networking website , Facebook.com , as an intervention to maintain or enhance cognitive function in older adults . Method Forty-one older adults were assigned to learn and use Facebook ( n = 14 ) or an online diary website ( active control , n = 13 ) for 8 weeks or placed on a waitlist ( n = 14 ) . Outcome measures included neuropsychological tests of executive functions , memory , and processing speed and self-report question naires about social engagement . Results The Facebook group showed a significant increase in a composite measure of updating , an executive function factor associated with complex working memory tasks , compared to no significant change in the control groups . Other measures of cognitive function and social support showed no differential improvement in the Facebook group . Discussion Learning and using an online social networking site may provide specific benefits for complex working memory in a group of healthy older adults . This may reflect the particular cognitive dem and s associated with online social networking and /or the benefits of social engagement more generally Background The beneficial effects of brain training games are expected to transfer to other cognitive functions , but these beneficial effects are poorly understood . Here we investigate the impact of the brain training game ( Brain Age ) on cognitive functions in the elderly . Methods and Results Thirty-two elderly volunteers were recruited through an advertisement in the local newspaper and r and omly assigned to either of two game groups ( Brain Age , Tetris ) . This study was completed by 14 of the 16 members in the Brain Age group and 14 of the 16 members in the Tetris group . To maximize the benefit of the interventions , all participants were non-gamers who reported playing less than one hour of video games per week over the past 2 years . Participants in both the Brain Age and the Tetris groups played their game for about 15 minutes per day , at least 5 days per week , for 4 weeks . Each group played for a total of about 20 days . Measures of the cognitive functions were conducted before and after training . Measures of the cognitive functions fell into four categories ( global cognitive status , executive functions , attention , and processing speed ) . Results showed that the effects of the brain training game were transferred to executive functions and to processing speed . However , the brain training game showed no transfer effect on any global cognitive status nor attention . Conclusions Our results showed that playing Brain Age for 4 weeks could lead to improve cognitive functions ( executive functions and processing speed ) in the elderly . This result indicated that there is a possibility which the elderly could improve executive functions and processing speed in short term training . The results need replication in large sample s. Long-term effects and relevance for every-day functioning remain uncertain as yet . Trial Registration UMIN Clinical Trial Registry Objective To test the efficacy of a tablet computer training intervention to improve cognitive abilities of older adults . Design Prospect i ve r and omized controlled trial . Setting Community-based aging intervention study , Edinburgh , UK . Participants Forty-eight healthy older adults aged 65 to 76 years were recruited at baseline with no or minimal tablet experience ; 43 completed follow-up testing . Intervention Twenty-two participants attended a weekly 2-hour class for 10 weeks during which they learned how to use a tablet and various applications on it . Measurements A battery of cognitive tests from the WAIS-IV measuring the domains of Verbal Comprehension , Perceptual Processing , Working Memory , and Processing Speed , as well as health , psychological , and well-being measures . Results A 2 × 2 mixed model ANOVA suggested that the tablet intervention group ( N = 22 ) showed greater improvements in Processing Speed ( η2 = 0.10 ) compared with controls ( N = 21 ) , but did not differ in Verbal Comprehension , Perceptual Processing , or Working Memory ( η2 ranged from −0.03 to 0.04 ) . Conclusions Engagement in a new mentally challenging activity ( tablet training ) was associated with improved processing speed . Acquiring skills in later life , including those related to adopting new technologies , may therefore have the potential to reduce or delay cognitive changes associated with ageing . It is important to underst and how the development of these skills might further facilitate everyday activities , and also improve older adults ' quality of life Background Type 2 diabetes mellitus may alter the effect of physical activity on physical and cognitive function . Methods The Lifestyle Interventions and Independence for Elders ( LIFE ) trial r and omized controlled clinical trial of physical activity intervention ( walking , resistance training , and flexibility exercises )  enrolled adults aged 70 - 89 years who were sedentary and non-demented and who had functional limitations . St and ardized measures of physical and cognitive function were collected an average of 2 years post-r and omization . Differences between the intervention and control groups from 415 individuals with diabetes and 1,061 individuals without diabetes were contrasted with analyses of covariance . Results At 24 months , assignment to the physical activity intervention result ed in 0.019 m/s relatively faster average 400-meter gait speeds ( p = .007 overall ) both for individuals with and without diabetes ( intervention × diabetes interaction p = .99 ) . No benefits were seen on scores from a physical performance battery . Performance on cognitive tests was better among participants assigned to the physical activity intervention compared with control only for those with diabetes , particularly for global cognitive function ( p = .02 ) and delayed memory ( p = .005 ) , with mean [ 95 % confidence intervals ] for benefit from physical activity intervention of 0.114 [ 0.007,0.111 ] and 0.208 [ 0.030,0.387 ] st and ard deviations , respectively . Conclusions Physical activity intervention improved the gait speed of older , sedentary individuals with and without diabetes . The cognitive function benefits occurred among participants with , but not without , diabetes . The mechanisms through which physical activity affects physical and cognitive function in older adults may differ for individuals by diabetes status BACKGROUND Cognitive decline among seniors is a pressing health care issue . Specific exercise training may combat cognitive decline . We compared the effect of once-weekly and twice-weekly resistance training with that of twice-weekly balance and tone exercise training on the performance of executive cognitive functions in senior women . METHODS In this single-blinded r and omized trial , 155 community-dwelling women aged 65 to 75 years living in Vancouver were r and omly allocated to once-weekly ( n = 54 ) or twice-weekly ( n = 52 ) resistance training or twice-weekly balance and tone training ( control group ) ( n = 49 ) . The primary outcome measure was performance on the Stroop test , an executive cognitive test of selective attention and conflict resolution . Secondary outcomes of executive cognitive functions included set shifting as measured by the Trail Making Tests ( parts A and B ) and working memory as assessed by verbal digit span forward and backward tests . Gait speed , muscular function , and whole-brain volume were also secondary outcome measures . RESULTS Both resistance training groups significantly improved their performance on the Stroop test compared with those in the balance and tone group ( P < or = .03 ) . Task performance improved by 12.6 % and 10.9 % in the once-weekly and twice-weekly resistance training groups , respectively ; it deteriorated by 0.5 % in the balance and tone group . Enhanced selective attention and conflict resolution was significantly associated with increased gait speed . Both resistance training groups demonstrated reductions in whole-brain volume compared with the balance and tone group at the end of the study ( P < or = .03 ) . CONCLUSION Twelve months of once-weekly or twice-weekly resistance training benefited the executive cognitive function of selective attention and conflict resolution among senior women . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00426881 BACKGROUND Japan is one of the most rapidly ageing societies in the world . A number of municipalities have started services for the prevention of cognitive decline for community-dwelling elderly individuals , but the effectiveness of these services is currently insufficient . Our study explored the efficacy of a comprehensive intervention programme consisting of physical and leisure activities to prevent cognitive decline in community-dwelling elderly subjects . METHOD We administered a 12-week intervention programme consisting of physical and leisure activities aim ed at enhancing participants ' motivation to participate and support one another by providing a pleasant atmosphere , empathetic communication , praise , and errorless support . This programme for the prevention of cognitive decline was conducted as a service by the city of Maebashi . All participants underwent the Five-Cog test , which evaluated the cognitive domains of attention , memory , visuospatial function , language , and reasoning . Executive function was evaluated by the Wechsler Digit Symbol Substitution Test and Yamaguchi Kanji-Symbol Substitution Test . Subjective health status , level of social support , functional capacity , subjective quality of life , and depressive symptoms were assessed with a question naire . Grip strength test , timed up- and -go test , 5-m maximum walking times test , and functional reach test were performed to evaluate physical function . Fifty-two participants were r and omly allocated to  intervention ( n = 26 ) and control ( n = 26 ) groups . Twenty-six participants , aged between 65 - 87 years , received intervention once a week at a community centre . The programme was conducted by health-care professionals , with the help of senior citizen volunteers . RESULTS The intervention group ( n = 19 ) showed significant improvement on the analogy task of the Five-Cog test ( F(1,38 ) = 4.242 , P = 0.046 ) and improved quality of life ( F(1,38 ) = 4.773 , P = 0.035 ) as compared to the control group ( n = 24 ) . CONCLUSION A community-based 12-week intervention programme that aim ed to enhance motivation to participate in activities result ed in improvements in some aspects of cognitive function and quality of life .  Senior citizens who volunteered in the present intervention enabled the smooth implementation of the programme and alleviated the burden on professional staff OBJECTIVE to test the effect of a 16-week multimodal exercise program on neurocognitive and physical functioning and brain-derived neurotrophic factor ( BDNF ) . DESIGN a single-blinded , parallel-group r and omised controlled trial . SETTING S university campus and community-based halls . SUBJECTS forty-nine women aged 65 to 75 years , with no cognitive impairment and not undertaking more than 1 h of formal exercise training per week . METHODS the intervention group attended a 60-min multimodal class twice each week which included cardiovascular , strength and motor fitness training . The primary outcome was neurocognitive functioning and secondary outcomes were physical functioning and plasma levels of BDNF . RESULTS twenty-five participants were r and omised to the intervention group and 24 to the control group . One control participant withdrew before follow-up data collection . The intervention group performed significantly better than the control group at follow-up ( when controlled for baseline ) in the Trail Making test A and B , the California Older Adult Stroop test ( Word , Interference and Total scores ) , Controlled Oral Word Association test and the Timed Up- and -Go test , Six-Minute Walk test , One-Legged Stance test and plasma BDNF . CONCLUSION this multimodal exercise program result ed in neurocognitive and physical performance improvements and increased levels of plasma BDNF , in older women , when compared with controls . This RCT provides evidence that a multimodal exercise intervention can achieve larger effect sizes than those generally result ing from single modality interventions . Increases in BDNF levels imply neurogenesis may be a component of the mechanism underpinning the cognitive improvements associated with multimodal exercise . TRIAL REGISTRATION Australian and New Zeal and Clinical Trial Registration Number : ANZCTR12612000451808 Background Physical activity reduces the incidence and progression of cognitive impairment . Cognitive-motor dual-task training , which requires dividing attention between cognitive tasks and exercise , may improve various cognitive domains ; therefore , we examined the effect of dual-task training on the executive functions and on plasma amyloid β peptide ( Aβ ) 42/40 ratio , a potent biomarker of Alzheimer ’s disease , in healthy elderly people . Methods Twenty-seven sedentary elderly people participated in a 12-week r and omized , controlled trial . The subjects assigned to the dual-task training ( DT ) group underwent a specific cognitive-motor dual-task training , and then the clinical outcomes , including cognitive functions by the Modified Mini-Mental State ( 3MS ) examination and the Trail-Making Test ( TMT ) , and the plasma Aβ 42/40 ratio following the intervention were compared with those of the control single-task training ( ST ) group by unpaired t-test . Results Among 27 participants , 25 completed the study . The total scores in the 3MS examination as well as the muscular strength of quadriceps were equally improved in both groups after the training . The specific cognitive domains , “ registration & recall ” , “ attention ” , “ verbal fluency & underst and ing ” , and “ visuospatial skills ” were significantly improved only in the DT group . Higher scores in “ attention ” , “ verbal fluency & underst and ing ” , and “ similarities ” were found in the DT group than in the ST group at post-intervention . The absolute changes in the total ( 8.5 ± 1.6 vs 2.4 ± 0.9 , p = 0.004 , 95 % confidence interval ( CI ) 0.75―3.39 ) and in the scores of “ attention ” ( 1.9 ± 0.5 vs −0.2 ± 0.4 , p = 0.004 , 95 % CI 2.25―9.98 ) were greater in the DT group than in the ST group . We found no changes in the TMT results in either group . Plasma Aβ 42/40 ratio decreased in both groups following the training ( ST group : 0.63 ± 0.13 to 0.16 ± 0.03 , p = 0.001 ; DT group : 0.60 ± 0.12 to 0.25 ± 0.06 , p = 0.044 ) , although the pre- and post-intervention values were not different between the groups for either measure . Conclusions Cognitive-motor dual-task training was more beneficial than single-task training alone in improving broader domains of cognitive functions of elderly persons , and the improvement was not directly due to modulating Aβ metabolism Purpose Physical exercise and cognitive training have been shown to enhance cognition among older adults . However , few studies have looked at the potential synergetic effects of combining physical and cognitive training in a single study . Prior trials on combined training have led to interesting yet equivocal results . The aim of this study was to examine the effects of combined physical and cognitive interventions on physical fitness and neuropsychological performance in healthy older adults . Methods Seventy-six participants were r and omly assigned to one of four training combinations using a 2 × 2 factorial design . The physical intervention was a mixed aerobic and resistance training program , and the cognitive intervention was a dual-task ( DT ) training program . Stretching and toning exercises and computer lessons were used as active control conditions  . Physical and cognitive measures were collected pre- and postintervention . Results All groups showed equivalent improvements in measures of functional mobility . The aerobic – strength condition led to larger effect size in lower body strength , independently of cognitive training . All groups showed improved speed of processing and inhibition abilities , but only participants who took part in the DT training , independently of physical training , showed increased task-switching abilities . The level of functional mobility after intervention was significantly associated with task-switching abilities . Conclusion Combined training did not yield synergetic effects . However , DT training did lead to transfer effects on executive performance in neuropsychological tests . Both aerobic-resistance training and stretching-toning exercises can improve functional mobility in older adults CONTEXT There are potential benefits of mind-body techniques on cognitive function because the techniques involve an active attentional or mindfulness component , but this has not been fully explored . OBJECTIVE To determine the effect of yoga on cognitive function , fatigue , mood , and quality of life in seniors . DESIGN R and omized , controlled trial comparing yoga , exercise , and wait-list control groups . PARTICIPANTS One hundred thirty-five generally healthy men and women aged 65 - 85 years . INTERVENTION Participants were r and omized to 6 months of Hatha yoga class , walking exercise class , or wait-list control . Subjects assigned to classes also were asked to practice at home . MAIN OUTCOME MEASURES Outcome assessment s performed at baseline and after the 6-month period included a battery of cognitive measures focused on attention and alertness , the primary outcome measures being performance on the Stroop Test and a quantitative electroencephalogram ( EEG ) measure of alertness ; SF-36 health-related quality of life ; Profile of Mood States ; Multi-Dimensional Fatigue Inventory ; and physical measures related to the interventions . RESULTS One hundred thirty-five subjects were recruited and r and omized . Seventeen subjects did not finish the 6-month intervention . There were no effects from either of the active interventions on any of the cognitive and alertness outcome measures . The yoga intervention produced improvements in physical measures ( eg , timed 1-legged st and ing , forward flexibility ) as well as a number of quality -of-life measures related to sense of well-being and energy and fatigue compared to controls . CONCLUSIONS There were no relative improvements of cognitive function among healthy seniors in the yoga or exercise group compared to the wait-list control group . Those in the yoga group showed significant improvement in quality -of-life and physical measures compared to exercise and wait-list control groups Growing evidence supports the use of physical training interventions to improve both physical and cognitive performances in healthy older adults . Few studies have examined the impact of aerobic exercise on Stroop task performance , a measure of executive functions . In the current 3-month aerobic training study , 50 older adults ( mean age = 67.96 ± 6.25 years ) were r and omly assigned to either a three-month physical training group or to a control group ( waiting list ) . Training sessions were 3 times per week for 60 minutes . All participants completed pre- and post-test measures of cognitive performance using the modified Stroop task and physical performance ( Rockport one-mile test ) . Compared to controls , the training group showed significant improvements in physical capacity ( P < 0.001 ) and enhanced Stroop performance , but only in the inhibition/switching condition ( P < 0.03 ) . Furthermore , the increase in aerobic capacity induced by the training regimen correlated negatively with reaction time in the inhibition/switching condition of the Stroop task at posttest ( r = −0.538 ; P = 0.007 ) . Importantly , the reported gains in cognitive performance were observed after only three months of physical training . Taken together , the results suggest that even short-term physical interventions can enhance older adults ' executive functions Abstract : A r and omised controlled trial was conducted to determine whether a 12–month program of group exercise had beneficial effects on physiological and cognitive functioning and mood in 187 older community – dwelling women . The  exercisers ( n= 94 ) and controls ( n= 93 ) were well matched in terms of the test measures and a number of health and life – style assessment s. The mean number of classes attended by the 71 exercise subjects who completed the program was 59.0 ( range 26 to 82 ) . At the end of the trial , the exercisers showed significant improvements in reaction time , strength , memory span and measures of wellbeing when compared with the controls . There was also an indication that anxiety had been reduced in the exercisers . Within the exercise group , improvements in memory span were associated with concomitant improvements in both reaction time and muscle strength . Also , within this group , initial mood measures were significantly inversely associated with improvements at retest , which suggests that the program may have normalised mood states in subjects who had high initial depression , anxiety and stress levels , rather than inducing improvements in all subjects . These findings suggest that group exercise has beneficial effects on physiological and cognitive functioning and wellbeing in older people PURPOSE The purpose of this study was to assess the impact of 24 wk of resistance training at two different intensities on cognitive functions in the elderly . METHODS Sixty-two elderly individuals were r and omly assigned to three groups : CONTROL ( N = 23 ) , experimental moderate ( EMODERATE ; N = 19 ) , and experimental high ( EHIGH ; N = 20 ) . The volunteers were assessed on physical , hemodynamic , cognitive , and mood parameters before and after the program . RESULTS On the 1 RM test ( P < 0.001 ) , the two experimental groups performed better than the CONTROL group , but they did not show differences between themselves . The EHIGH group gained more lean mass ( P = 0.05 ) than the CONTROL group and performed better on the following tests : digit span forward ( P < 0.001 ) , Corsi 's block-tapping task backward ( P = 0.001 ) , similarities ( P = 0.03 ) , Rey-Osterrieth complex figure immediate recall ( P = 0.02 ) , Toulouse-Pieron concentration test errors ( P = 0.01 ) , SF-36 ( general health ) ( P = 0.04 ) , POMS ( tension-anxiety , P = 0.04 ; depression-dejection , P = 0.03 ; and total mood disorder , P = 0.03 ) . The EMODERATE group scored higher means than the CONTROL group on digit span forward ( P < 0.001 ) , Corsi 's block-tapping task backward ( P = 0.01 ) , similarities ( P = 0.02 ) , Rey-Osterrieth complex figure immediate recall ( P = 0.02 ) , SF-36 ( general health , P = 0.005 ; vitality , P = 0.006 ) , POMS ( tension-anxiety , P = 0.001 ; depression-dejection , P = 0.006 ; anger-hostility , P = 0.006 ; fatigue-inertia , P = 0.02 ; confusion-bewilderment , P = 0.02 ; and total mood disorder , P = 0.001 ) . We also found that IGF-1 serum levels were higher in the experimental groups ( EMODERATE , P = 0.02 ; EHIGH , P < 0.001 ) . CONCLUSIONS Moderate- and high-intensity resistance exercise programs had equally beneficial effects on cognitive functioning BACKGROUND Cholinergic deficits might contribute to vascular cognitive impairment . Trials of cholinesterase inhibitors in patients with vascular dementia are difficult because of heterogeneous disease mechanisms and overlap between vascular and Alzheimer 's disease ( AD ) pathology in the age-group recruited . Cerebral autosomal dominant arteriopathy with subcortical infa rcts and leucoencephalopathy ( CADASIL ) is a genetic form of subcortical ischaemic vascular dementia . It represents a homogeneous disease process , and because of CADASIL 's early onset , comorbid AD pathology is rare . We did a multicentre , 18-week , placebo-controlled , double-blind , r and omised parallel-group trial to determine whether the cholinesterase inhibitor donepezil improves cognition in patients with CADASIL . METHODS 168 patients with CADASIL ( mean age 54.8 years ) were assigned to 10 mg donepezil per day ( n=86 ) or placebo ( n=82 ) by a computer-generated r and omisation protocol . Inclusion criteria included a mini-mental state examination ( MMSE ) score of 10 - 27 or a trail making test ( TMT ) B time score at least 1.5 SD below the mean , after adjustment for age and education . The primary endpoint was change from baseline in the score on the vascular AD assessment scale cognitive subscale ( V-ADAS-cog ) at 18 weeks . Secondary endpoints included scores on the ADAS-cog , MMSE , TMT A time and B time , Stroop , executive interview-25 ( EXIT25 ) , CLOX , disability assessment for dementia , and sum of boxes of the clinical dementia rating scale . Analysis was done by intention to treat . This trial is registered with Clinical Trials.gov , number NCT00103948 . FINDINGS 161 patients were analysed . There was no significant difference between donepezil ( n=84 ) and placebo ( n=77 ) in the primary endpoint . The least-squares mean change from baseline score was -0.81 ( SE 0.59 ) in the placebo group and -0.85 ( SE 0.57 ) in the donepezil group ( p=0.956 ) . There was a significant treatment effect favouring donepezil on the following secondary outcomes : TMT B time ( p=0.023 ) , TMT A time ( p=0.015 ) , and EXIT25 ( p=0.022 ) . Ten donepezil-treated patients discontinued treatment due to adverse events compared to seven placebo-treated patients . INTERPRETATION Donepezil had no effect on the primary endpoint , the V-ADAS-cog score in CADASIL patients with cognitive impairment . Improvements were noted on several measures of executive function , but the clinical relevance of these findings is not clear . Our findings may have implication s for future trial design in subcortical vascular cognitive impairment We used a moderate aerobic exercise program for 24 weeks to measure the positive impact of physical activity on oxidative stress and inflammatory markers and its association with cognitive performance in healthy older adults . A total of 100 healthy subjects ( 65–95 Yrs ) were r and omly classified into two groups : control group ( n = 50 ) and exercise group ( n = 50 ) . Cognitive functioning , physical activity score , MDA , 8-OHdG , TAC , and hs-CRP were assessed using LOTCA battery , prevali date d PA question naire , and immunoassay techniques . LOTCA 7-set scores of cognitive performance showed a significant correlation with physical activity status and the regulation of both oxidative stress free radicals and inflammatory markers in all older subjects following 24 weeks of moderate exercise . Physically active persons showed a higher cognitive performance along with reduction in the levels of MDA , 8-OHdG , and hs-CRP and increase in TAC activity compared with sedentary participants . Cognitive performance correlated positively with the increase in TAC activity and physical fitness scores and negatively with MDA , 8-OHdG , and hs-CRP , respectively . There was a significant improvement in motor praxis , vasomotor organization , thinking operations , and attention and concentration among older adults . In conclusion , moderate aerobic training for 24 weeks has a positive significant effect in improving cognitive functions via modulating redox and inflammatory status of older adults Epidemiological studies suggest a dose-response relationship exists between physical activity and cognitive outcomes . However , no direct data from r and omized trials exists to support these indirect observations . The purpose of this study was to explore the possible relationship of aerobic exercise dose on cognition .  Underactive or sedentary participants without cognitive impairment were r and omized to one of four groups : no-change control , 75 , 150 , and 225 minutes per week of moderate-intensity semi-supervised aerobic exercise for 26-weeks in a community setting . Cognitive outcomes were latent residual scores derived from a battery of 16 cognitive tests : Verbal Memory , Visuospatial Processing , Simple Attention , Set Maintenance and Shifting , and Reasoning . Other outcome measures were cardiorespiratory fitness ( peak oxygen consumption ) and measures of function functional health . In intent-to-treat ( ITT ) analyses ( n = 101 ) , cardiorespiratory fitness increased and perceived disability decreased in a dose-dependent manner across the 4 groups . No other exercise-related effects were observed in ITT analyses . Analyses restricted to individuals who exercised per- protocol ( n = 77 ) demonstrated that Simple Attention improved equivalently across all exercise groups compared to controls and a dose-response relationship was present for Visuospatial Processing . A clear dose-response relationship exists between exercise and cardiorespiratory fitness . Cognitive benefits were apparent at low doses with possible increased benefits in visuospatial function at higher doses but only in those who adhered to the exercise protocol . An individual ’s cardiorespiratory fitness response was a better predictor of cognitive gains than exercise dose ( i.e. , duration ) and thus maximizing an individual ’s cardiorespiratory fitness may be an important therapeutic target for achieving cognitive benefits . Trial Registration Clinical Trials.gov Cognitive decline in aging is a pressing issue associated with significant healthcare costs and deterioration in quality of life . Previously , we reported the successful use of a novel brain-computer interface ( BCI ) training system in improving symptoms of attention deficit hyperactivity disorder . Here , we examine the feasibility of the BCI system with a new game that incorporates memory training in improving memory and attention in a pilot sample of healthy elderly . This study investigates the safety , usability and acceptability of our BCI system to elderly , and obtains an efficacy estimate to warrant a phase III trial . Thirty-one healthy elderly were r and omized into intervention ( n = 15 ) and waitlist control arms ( n = 16 ) . Intervention consisted of an 8-week training comprising 24 half-hour sessions . A usability and acceptability question naire was administered at the end of training . Safety was investigated by querying users about adverse events after every session . Efficacy of the system was measured by the change of total score from the Repeatable Battery for the Assessment of Neuropsychological Status ( RBANS ) before and after training . Feedback on the usability and acceptability question naire was positive . No adverse events were reported for all participants across all sessions . Though the median difference in the RBANS change scores between arms was not statistically significant , an effect size of 0.6SD was obtained , which reflects potential clinical utility according to Simon ’s r and omized phase II trial design . Pooled data from both arms also showed that the median change in total scores pre and post-training was statistically significant ( Mdn = 4.0 ; p<0.001 ) . Specifically , there were significant improvements in immediate memory ( p = 0.038 ) , visuospatial/constructional ( p = 0.014 ) , attention ( p = 0.039 ) , and delayed memory ( p<0.001 ) scores . Our BCI-based system shows promise in improving memory and attention in healthy elderly , and appears to be safe , user-friendly and acceptable to senior users . Given the efficacy signal , a phase III trial is warranted . Trial Registration Clinical Trials.gov Physical and cognitive training seem to counteract age-related decline in physical and mental function . Recently , the possibility of integrating cognitive dem and s into physical training has attracted attention . The purpose of this study was to evaluate the effects of twelve weeks of design ed physical-cognitive training on executive cognitive function and gait performance in older adults . Thirty-six healthy , active individuals aged 72.30 ± 5.84 years were assigned to two types of physical training with major focus on physical single task ( ST ) training ( n = 16 ) and physical-cognitive dual task ( DT ) training ( n = 20 ) , respectively . They were tested before and after the intervention for executive function ( inhibition , working memory ) through R and om Number Generation and for gait ( walking with/without negotiating hurdles ) under both single and dual task ( ST , DT ) conditions . Gait performance improved in both groups , while inhibitory performance decreased after exercise training with ST focus but tended to increase after training with physical-cognitive DT focus . Changes in inhibition performance were correlated with changes in DT walking performance with group differences as a function of motor task complexity ( with/without hurdling ) . The study supports the effectiveness of group exercise classes for older individuals to improve gait performance  , with physical-cognitive DT training selectively counteracting the age-related decline in a core executive function essential for daily living OBJECTIVES Frailty is a state of vulnerability associated with increased risks of fall , hospitalization , cognitive deficits , and psychological distress . Studies with healthy senior suggest that physical exercise can help improve cognition and quality of life . Whether frail older adults can show such benefits remains to be documented . METHOD A total of 83 participants aged 61 - 89 years were assigned to an exercise-training group ( 3 times a week for 12 weeks ) or a control group ( waiting list ) . Frailty was determined by a complete geriatric examination using specific criteria . Pre- and post-test measures assessed physical capacity , cognitive performance , and quality of life . RESULTS Compared with controls , the intervention group showed significant improvement in physical capacity ( functional capacities and physical endurance ) , cognitive performance ( executive functions , processing speed , and working memory ) , and quality of life ( global quality of life , leisure activities , physical capacity , social/family relationships , and physical health ) . Benefits were overall equivalent between frail and nonfrail participants . DISCUSSION Physical exercise training leads to improved cognitive functioning and psychological well-being in frail older adults BACKGROUND Several reports suggest beneficial impacts of either physical or mental activity on cognitive function  in old age . However , the differential effects of complex mental and physical activities on cognitive performance in humans remain to be clarified . METHODS This r and omized controlled trial evaluates a cognitive and a physical st and ardized 6-month activity intervention ( 3 x 1.5 h/wk ) conducted in Berlin ( Germany ) . Two hundred fifty nine healthy women aged 70 - 93 years were r and omized to a computer course ( n = 92 ) , an exercise course ( n = 91 ) , or a control group ( n = 76 ) , of whom 230 completed the 6-month assessment . Group differences in change over a period of 6 months in episodic memory ( story recall , possible range , 0 - 21 ; word recall , possible range , 0 - 16 ) , executive control ( working memory , ie , time quotient of Trail Making Tests B/A ) , and verbal fluency were evaluated by analyses of covariance ( intention to treat ) adjusting for baseline , fluid intelligence , and educational level . RESULTS In contrast to the control group , both the exercise group , DeltaM ( SD ) = 2.09 ( 2.66 ) , p < .001 , and the computer group , DeltaM ( SD ) = 1.89 ( 2.88 ) , p < .001 , showed improved delayed story recall . They maintained performance in delayed word recall and working memory ( time measure ) as opposed to the control group that showed a decline , DeltaM ( SD ) = -0.91 ( 2.15 ) , p = .001 , and DeltaM ( SD ) = 0.24 ( 0.68 ) , p = .04 , respectively . CONCLUSIONS In healthy older women , participation in new stimulating activities contributes to cognitive fitness and might delay cognitive decline .  Exercise and computer classes seem to generate equivalent beneficial effects During aging , the prefrontal cortex ( PFC ) undergoes age-dependent neuronal changes influencing cognitive and motor functions . Motor-learning interventions are hypothesized to ameliorate motor and cognitive deficits in older adults . Especially , video game-based physical exercise might have the potential to train motor in combination with cognitive abilities in older adults . The aim of this study was to compare conventional balance training with video game-based physical exercise , a so-called exergame , on the relative power ( RP ) of electroencephalographic ( EEG ) frequencies over the PFC , executive function ( EF ) , and gait performance .  Twenty-seven participants ( mean age 79.2 ± 7.3 years ) were r and omly assigned to one of two groups . All participants completed 24 trainings including three times a 30 min session/week . The EEG measurements showed that theta RP significantly decreased in favor of the exergame group [ L(14 ) = 6.23 , p = 0.007 ] . Comparing pre- vs. post-test , EFs improved both within the exergame ( working memory : z = −2.28 , p = 0.021 ; divided attention auditory : z = −2.51 , p = 0.009 ; divided attention visual : z = −2.06 , p = 0.040 ; go/no-go : z = −2.55 , p = 0.008 ; set-shifting : z = −2.90 , p = 0.002 ) and within the balance group ( set-shifting : z = −2.04 , p = 0.042 ) . Moreover , spatio-temporal gait parameters primarily improved within the exergame group under dual-task conditions ( speed normal walking : z = −2.90 , p = 0.002 ; speed fast walking : z = −2.97 , p = 0.001 ; cadence normal walking : z = −2.97 , p = 0.001 ; stride length fast walking : z = −2.69 , p = 0.005 ) and within the balance group under single-task conditions ( speed normal walking : z = −2.54 , p = 0.009 ; speed fast walking : z = −1.98 , p = 0.049 ; cadence normal walking : z = −2.79 , p = 0.003 ) . These results indicate that exergame training as well as balance training positively influence prefrontal cortex activity and /or function in varying proportion OBJECTIVES To investigate whether a 12-week physical and cognitive exercise program can improve cognitive function and brain activation efficiency in community-dwelling older adults . DESIGN R and omized controlled trial . SETTING Kyoto , Japan . PARTICIPANTS Community-dwelling older adults ( N = 48 ) were r and omized into an exercise group ( n = 24 ) and a  control group ( n = 24 ) . INTERVENTION Exercise group participants received a weekly dual task-based multimodal exercise class in combination with pedometer-based daily walking exercise during the 12-week intervention phase . Control group  participants did not receive any intervention and were instructed to spend their time as usual during the intervention phase . MEASUREMENTS The outcome measures were global cognitive function , memory function , executive function , and brain activation ( measured using functional magnetic resonance imaging ) associated with visual short-term memory . RESULTS Exercise group participants had significantly greater postintervention improvement in memory and executive functions than the control group ( P < .05 ) . In addition , after the intervention , less activation was found in several brain regions associated with visual short-term memory , including the prefrontal cortex , in the exercise group ( P < .001 , uncorrected ) . CONCLUSION A 12-week physical and cognitive exercise program can improve the efficiency of brain activation during cognitive tasks in older adults , which is associated with improvements in memory and executive function Objective To evaluate the effects of Tai chi exercise on balance , sleep quality , and cognitive performance in community-dwelling elderly in Vinh city , Vietnam . Design A r and omized controlled trial . Participants One hundred two subjects were recruited . Intervention Subjects were divided r and omly into two groups . The Tai chi group was assigned 6 months ’ Tai chi training . The control group was instructed to maintain their routine daily activities . Outcome measures The Falls Efficacy Scale ( FES ) , Pittsburgh Sleep Quality Index ( PSQI ) , and Trail Making Test ( TMT ) were used as primary outcome measures . Results Participants in the Tai chi group reported significant improvement in TMT ( part A ) ( F [ 1 , 71 ] = 78.37 , P < 0.001 ) and in TMT ( part B ) , ( F [ 1 , 71 ] = 175.00 , P < 0.001 ) in comparison with the control group . Tai chi participants also reported better scores in FES ( F [ 1 , 71 ] = 96.90 , P < 0.001 ) and in PSQI ( F [ 1,71 ] = 43.69 , P = 0.001 ) than the control group . Conclusion Tai chi is beneficial to improve balance , sleep quality , and cognitive performance of the elderly [ Purpose ] To investigate the effect of Tai Chi on cognitive and physical function  in the elderly . [ Subjects and Methods ] A r and omized trial design was used . A total 150 subjects were enrolled and were divided into Tai Chi and control groups . Subjects in the Tai Chi group participated Tai Chi for 6 months , and subjects in the control group participated in other non-athletic activities . [ Results ] There were no differences between the groups in the one leg st and ing time with eyes open , left grip strength , or the Frontal Assessment Battery at bedside after 3 and 6 months of intervention . The Mini-Mental State Examination scores after 3 and 6 months were higher in the Tai Chi group than in the control group . The right grip strength after 3 months increased more in the Tai Chi group than in the control group . Both the 5-m high walking speed and 10-m normal walking speed were significantly lower after 3 and 6 months of Tai Chi practice . [ Conclusion ] These results suggest that regular Tai Chi practice may improve cognitive and physical function in the elderly Several studies investigating the relationship between physical activity and cognition showed that exercise interventions might have beneficial effects on working memory , executive functions as well as motor fitness in old adults . Recently , movement based video games ( exergames ) have been introduced to have the capability to improve cognitive function in older adults . Healthy aging is associated with a loss of cognitive , as well as sensorimotor functions . During exergaming , participants are required to perform physical activities while being simultaneously surrounded by a cognitively challenging environment . However , only little is known about the impact of exergame training interventions on a broad range of motor , sensory , and cognitive skills . Therefore , the present study aims at investigating the effects of an exergame training over 6 weeks on cognitive , motor , and sensory functions in healthy old participants . For this purpose , 30 neurologically healthy older adults were r and omly assigned to either an experimental ( ETG , n = 15 , 1 h training , twice a week ) or a control group ( NTG , n = 15 , no training ) . Several cognitive tests were performed before and after exergaming in order to capture potential training-induced effects on processing speed as well as on executive functions . To measure the impact of exergaming on sensorimotor performance , a test battery consisting of pinch and grip force of the h and , tactile acuity , eye-h and coordination , flexibility , reaction time , coordination , and static balance were additionally performed . While we observed significant improvements in the trained exergame ( mainly in tasks that required a high load of coordinative abilities ) , these gains did not result in differential performance improvements when comparing ETG and NTG . The only exergaming-induced difference was a superior behavioral gain in fine motor skills of the left h and in ETG compared to NTG . In an exploratory analysis , within-group comparison revealed improvements in sensorimotor and cognitive tasks ( ETG ) while NTG only showed an improvement in a static balance test . Taken together , the present study indicates that even though exergames might improve gaming performance , our behavioral assessment was probably not sensitive enough to capture exergaming-induced improvements . Hence , we suggest to use more tailored outcome measures in future studies to assess potential exergaming-induced changes BACKGROUND More evidence is needed to conclude that a specific program of exercise and /or cognitive training warrants prescription for the prevention of cognitive decline . We examined the effect of a group-based st and ard exercise program for older adults , with and without dual-task training , on cognitive function in older adults without dementia . METHODS We conducted a proof-of-concept , single-blinded , 26-wk r and omized controlled trial whereby participants recruited from preexisting exercise classes at the Canadian Centre for Activity and Aging in London , Ontario , were r and omized to the intervention group ( exercise + dual-task [ EDT ] )  or the control group  ( exercise only [ EO ] ) . Each week ( 2 or 3 d · wk(-1 ) ) , both groups accumulated a minimum of 50 min of aerobic exercise ( target 75 min ) from st and ard group classes and completed 45 min of beginner-level square-stepping exercise . The EDT group was also required to answer cognitively challenging questions while doing beginner-level square-stepping exercise ( i.e. , dual-task training ) . The effect of interventions on st and ardized global cognitive function ( GCF ) scores at 26 wk was compared between the groups using the linear mixed effects model approach . RESULTS Participants ( n = 44 ; 68 % female ; mean [ SD ] age : 73.5 [ 7.2 ] yr ) had on average , objective evidence of cognitive impairment  ( Montreal Cognitive Assessment scores , mean [ SD ] : 24.9 [ 1.9 ] ) but not dementia  ( Mini-Mental State Examination scores , mean [ SD ] : 28.8 [ 1.2 ] ) . After 26 wk , the EDT group showed greater improvement in GCF scores compared with the EO group ( difference between groups in mean change [ 95 % CI ] : 0.20 SD [ 0.01 - 0.39 ] , P = 0.04 ) . CONCLUSIONS A 26-wk group-based exercise program combined with dual-task training improved GCF in community-dwelling older adults without dementia Our study investigated the effect of a music training program on working memory ( verbal memory , visual memory , and as a part of central executive processing working memory ) in older adults . The experimental group was  musically trained ( drumming and singing ) , whereas one control group received a literature training program and a second control group was untrained . We r and omly assigned 24 participants ( all females ; M = 77 years and 3 months ) to the music group , the literature group , and the untrained group . The training groups were trained for 15 weeks . The three groups did not differ significantly in age , socioeconomic status , music education , musical aptitude , cognitive abilities , or depressive symptoms . We did not find differences in the music group in central executive function . However , we found a potential effect of music training on verbal memory and an impact of music training on visual memory . Musically trained participants remembered more words from a word list than both control groups , and they were able to remember more symbol sequences correctly than the control groups . Our findings show a possible effect of music training on verbal and visual memory in older people Background The prevention of falls among older people is a major public health challenge . Exercises that challenge balance are recognized as an efficacious fall prevention strategy . Given that small-scale trials have indicated that diverse dance styles can improve balance and gait of older adults , two of the strongest risk factors for falls in older people , this study aim ed to determine whether social dance is effective in i ) reducing the number of falls and ii ) improving physical and cognitive fall-related risk factors . Methods and Findings A parallel two-arm cluster r and omized controlled trial was undertaken in 23 self-care retirement villages ( clusters ) around Sydney , Australia . Eligible villages had to have an appropriate hall for dancing , house at least 60 residents , and not be currently offering dance as a village activity . Retirement villages were r and omised using a computer generated r and omisation method , constrained using minimisation . Eligible participants had to be a resident of the village , be able to walk at least 50 m , and agree to undergo physical and cognitive testing without cognitive impairment . Residents of intervention villages ( 12 clusters ) were offered twice weekly one-hour social dancing classes ( folk or ballroom dancing ) over 12 mo ( 80 h in total ) . Programs were st and ardized across villages and were delivered by eight dance teachers . Participants in the control villages ( 11 clusters ) were advised to continue with their regular activities . Main outcomes : falls during the 12 mo trial and Trail Making Tests . Secondary outcomes : The Physiological Performance Assessment ( i.e. , postural sway , proprioception , reaction time , leg strength ) and the Short Physical Performance Battery ; health-related physical and mental quality of life from the Short-Form 12 ( SF-12 ) Survey . Data on falls were obtained from 522 of 530 ( 98 % ) r and omised participants ( mean age 78 y , 85 % women ) and 424 ( 80 % ) attended the 12-mo re assessment , which was lower among folk dance participants ( 71 % ) than ballroom dancing ( 82 % ) or control participants ( 82 % , p = 0.04 ) . Mean attendance at  dance classes was 51 % . During the period , 444 falls were recorded ; there was no significant difference in fall rates between the control group ( 0.80 per person-year ) and the dance group ( 1.03 per person-year ) . Using negative binomial regression with robust st and ard errors the adjusted Incidence Rate Ratio ( IRR ) was 1.19 ( 95 % CI : 95 % CI = 0.83 , 1.71 ) . In exploratory post hoc subgroup analysis , the rate of falls was higher among dance participants with a history of multiple falls ( IRR = 2.02 , 95 % CI : 1.15 , 3.54 , p = 0.23 for interaction ) and with the folk dance intervention ( IRR = 1.68 , 95 % CI : 1.03 , 2.73 ) . There were no significant between-group differences in executive function test ( TMT-B = 2.8 s , 95 % CI : −6.2 , 11.8 ) . Intention to treat ( ITT ) analysis revealed no between-group differences at 12-mo follow-up in the secondary outcome measures , with the exception of postural sway , favouring the control group . Exploratory post hoc analysis by study completers and style indicated that ballroom dancing participants apparently improved their gait speed by 0.07 m/s relative to control participants ( 95 % CI : 0.00 , 0.14 , p = 0.05 ) . Study limitations included allocation to style based on logistical considerations rather than at r and om ; insufficient power to detect differential impacts of different dance styles and smaller overall effects ; variation of measurement conditions across villages ; and no assessment of more complex balance tasks , which may be more sensitive to changes brought about by dancing . Conclusions Social dancing did not prevent falls or their associated risk factors among these retirement villages ' residents . Modified dance programmes that contain " training elements " to better approximate structured exercise programs , targeted at low and high-risk participants , warrant investigation . Trial Registration The Australian New Zeal and Clinical Trials Registry OBJECTIVE To compare the effects of Tai Chi ( TC , n = 37 ) and Western exercise ( WE , n = 39 ) with an attention-control group ( C , n = 56 ) on physical and cognitive functioning in healthy adults age 69 + /- 5.8 yr , in a 2-phase r and omized trial . METHODS TC and WE involved combined class and home-based protocol s. Physical functioning included balance , strength , flexibility , and cardiorespiratory endurance . Cognitive functioning included semantic fluency and digit-span tests . Data were analyzed using intention-to-treat analysis . RESULTS At 6 mo , WE had greater improvements in upper body flexibility ( F = 4.67 , p = .01 ) than TC and C. TC had greater improvements in balance ( F = 3.36 , p = .04 ) and a cognitive-function measure ( F = 7.75 , p < .001 ) than WE and C. The differential cognitive-function improvements observed in TC were maintained through 12 mo . CONCLUSION The TC and WE interventions result ed in differential improvements in physical functioning among generally healthy older adults . TC led to improvement in an indicator of cognitive functioning that was maintained through 12 mo Background and aims : According to the concepts of ‘ use it or lose it ’ and cognitive reserve , cognitively challenging activities may boost cognitive abilities in older adults . Using computers and the internet provides divergent cognitive challenges to older persons , and the positive effects of computers and internet use on the qualify of life have been found in earlier studies . Methods : We investigated whether prolonged guided computer use by healthy older adults ( 64–75 ) may be beneficial to cognitive ability in a r and omized controlled study . The intervention consisted of brief training and subsequent use of a personal computer with an internet connection at home for a 12-month period . 191 participants were r and omly assigned to three groups : Intervention , Training/No intervention , or No training/No intervention . A fourth group consisted of 45 participants with no interest in computer use . The effect of the intervention was assessed by a range of well-established cognitive instruments that probed verbal memory , information processing speed , and cognitive flexibility . Data were collected at baseline and after four and twelve months . Results : Intensive interaction with a personal computer with st and ard software applications had no effect on cognitive measures ; no differences in changes in cognitive parameters over time were found between groups . Conclusion : Learning to use a computer and the internet does not benefit healthy , community-dwelling older adults with respect to many domains of cognitive functions . The implication s of these findings for future studies that use cognitive challenge to counteract usual cognitive aging are discussed Objective : To identify the most accurate cognitive measures in discriminating between individuals with presymptomatic AD and individuals who remained nondemented . Methods : During a 10-year prospect i ve community study , 120 nondemented subjects completed a battery of st and ard cognitive tests  and clinical ly manifested AD 1.5 years later . Performance on each of 16 cognitive tests was compared between these 120 presymptomatic cases and 483 controls who remained nondemented over the 10-year follow-up period . The area under the receiver operating characteristic ( AUC ) curve for each test was used to measure its accuracy of discrimination between cases and controls . Results : Among the 16 neuropsychological tests ,  Word List Delayed Recall  discriminated best between cases and controls ( AUC = 0.806 ) , followed by the  Word List 3rd Learning Trial  ( 0.787 ) ,  Word List 1st Learning Trial  ( 0.774 ) , and  Trail-making Test B ( 0.773 ) , compared to the  Mini-Mental State Examination ( MMSE )  ( 0.726 ) . Both  Word List Delayed Recall and Word List 3rd Learning Trial  were significantly more accurate than the  MMSE . The combination of Word List Delayed Recall and Trail-making Test B comprised the optimal set of cognitive measures , with the highest AUC ( 0.852 ) . Conclusion : Measures of delayed recall and executive functions were the best discriminators between those who would manifest AD 1.5 years later and those who would remain nondemented . These findings are relevant for the early detection of AD and , therefore , for prevention and early intervention trials . Executive dysfunction may be a subtle manifestation of incipient AD , along with memory dysfunction The relationship between mental exercise and mental aging is a controversial issue . People generally believe the so-called mental-exercise hypothesis , that is , the age-related decline in cognitive function is less pronounced for people who are mentally active , yet there is insufficient scientific evidence supporting this hypothesis . Previous r and omized controlled trial studies showed convincing beneficial effects of cognitive training on directly targeted cognitive functions . In this study , we performed a single-blind , r and omized controlled trial on cognitive intervention in 124 community-dwelling seniors ( age range , 70 to 86 ) and estimated the beneficial effects of non-targeted cognitive functions . As for cognitive intervention , the subjects were asked to solve systematized basic problems in reading and arithmetic every day for 6 months . Neuropsychological measures were determined prior to and 6 months after the intervention ( post-test ) by  mini-mental state examination ( MMSE ) , frontal assessment battery at bed side ( FAB ) , and digit-symbol substitution test ( DST ) of WAIS-R. The FAB and DST scores showed a statistically significant ( p<0.001 and p<0.01 , respectively ) improvement in the post-test compared with the pre-test , such improvement was maintained up to 6 months of follow-up tests in only the experimental group . The transfer effect of cognitive intervention by reading and solving arithmetic problems on non-targeted cognitive functions was demonstrated in this study . This study shows that daily mental training can improve cognitive functions in normal adults . Although general interests in brain training have been increasing in the public , evidence for its beneficial effects , particularly the positive transfer effect on non-targeted cognitive function still remains insufficient . Here , we introduce a new cognitive intervention program for normal aged people , the concept of which is derived from the knowledge of both brain science and clinical studies . We performed a carefully design ed single-blind , r and omized controlled study , and the results of this study showed convincing evidence that cognitive training provides the beneficial transfer effect IMPORTANCE The prevalence of cognitive impairment and dementia are projected to rise dramatically during the next 40 years , and strategies for maintaining cognitive function with age are critically needed . Physical or mental activity alone result in relatively small , domain-specific improvements in cognitive function in older adults ; combined interventions may have more global effects . OBJECTIVE To examine the combined effects of physical plus mental activity on cognitive function in older adults . DESIGN R and omized controlled trial with a factorial design . SETTING San Francisco , California . PARTICIPANTS A total of 126 inactive , community-residing older adults with cognitive complaints . INTERVENTIONS All participants engaged in home-based mental activity ( 1 h/d , 3 d/wk ) plus class-based physical activity ( 1 h/d , 3 d/wk ) for 12 weeks and were r and omized to either mental activity intervention ( MA-I ; intensive computer ) or mental activity control ( MA-C ; educational DVDs ) plus exercise intervention ( EX-I ; aerobic ) or exercise control ( EX-C ; stretching and toning ) ; a 2 × 2 factorial design was used so that there were 4 groups : MA-I/EX-I , MA-I/EX-C , MA-C/EX-1 , and MA-C/EX-C. MAIN OUTCOME MEASURES Global cognitive change based on a comprehensive neuropsychological test battery . RESULTS Participants had a mean age of 73.4 years ; 62.7 % were women , and 34.9 % were Hispanic or nonwhite . There were no significant differences between the groups at baseline . Global cognitive scores improved significantly over time ( mean , 0.16 SD ; P < .001 ) but did not differ between groups in the comparison between MA-I and MA-C ( ignoring exercise , P = .17 ) , the comparison between EX-I and EX-C ( ignoring mental activity , P = .74 ) , or across all 4 r and omization groups ( P = .26 ) . CONCLUSIONS AND RELEVANCE In inactive older adults with cognitive complaints , 12 weeks of physical plus mental activity was associated with significant improvements in global cognitive function with no evidence of difference between intervention and active control groups . These findings may reflect practice effects or may suggest that the amount of activity is more important than the type in this subject population . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00522899 Aerobic exercise training has been shown to attenuate cognitive decline and reduce brain atrophy with advancing age . The extent to which resistance exercise training improves cognition and prevents brain atrophy is less known , and few studies include long-term follow-up cognitive and neuroimaging assessment s. We report data from a r and omized controlled trial of 155 older women , who engaged in 52 weeks of resistance training ( either once- or twice-weekly ) or balance- and -toning ( twice-weekly ) .  Executive functioning and memory were assessed at baseline , 1-year follow-up ( i.e. , immediately post-intervention ) , and 2-year follow-up . A subset underwent structural magnetic resonance imaging scans at those time points . At 2-year follow-up , both frequencies of resistance training  promoted executive function compared to balance- and -toning ( st and ardized difference [d]=.31-.48 ) . Additionally , twice-weekly resistance training  promoted memory ( d=.45 ) , reduced cortical white matter atrophy ( d=.45 ) , and increased peak muscle power ( d=.27 ) at 2-year follow-up relative to balance- and -toning . These effects were independent of one another . These findings suggest resistance training may have a long-term impact on cognition and white matter volume in older women Video game training with older adults potentially enhances aspects of cognition that decline with aging and could therefore offer a promising training approach . Although , previous published studies suggest that training can produce transfer , many of them have certain shortcomings . This r and omized controlled trial ( RCT ; Clinical trials.gov ID : NCT02796508 ) tried to overcome some of these limitations by incorporating an active control group and the assessment of motivation and expectations . Seventy-five older volunteers were r and omly assigned to the experimental group trained for 16 sessions with non-action video games from Lumosity , a commercial platform ( http://www.lumosity.com/ ) or to an active control group trained for the same number of sessions with simulation strategy games . The final sample included 55 older adults ( 30 in the experimental group and 25 in the active control group ) . Participants were tested individually before and after training to assess working memory ( WM ) and selective attention and also reported their perceived improvement , motivation and engagement . The results showed improved performance across the training sessions . The main results were : ( 1 ) the experimental group did not show greater improvements in measures of selective attention and working memory than the active control group ( the opposite occurred in the oddball task ) ; ( 2 ) a marginal training effect was observed for the N-back task , but not for the Stroop task while both groups improved in the Corsi Blocks task . Based on these results , one can conclude that training with non-action games provide modest benefits for untrained tasks . The effect is not specific for that kind of training as a similar effect was observed for strategy video games . Groups did not differ in motivation , engagement or expectations The objective of the present study was to provide normative data for Trail Making Test ( TMT ) time to completion and performance errors among cognitively normal older adults , and to examine TMT error rates in conjunction with time scores for pre- clinical and clinical Alzheimer 's disease ( AD ) diagnostic decision-making . A sample of 526 individuals was classified into three diagnostic groups ( normal controls , N=269 ; mild cognitive impairment , MCI , N=200 ; AD , N=57 ) by a multidisciplinary consensus conference . Results indicated that performance differed among the three groups for  TMT A and B time scores as well as  TMT B error rate . Diagnostic classification accuracy ( i.e. , sensitivity , specificity , and positive and negative predictive powers ) is described for various combinations of the diagnostic groups . The findings show that  TMT B time and errors are independently meaningful scores , and both therefore have clinical utility in assessing individuals referred for dementia evaluations PURPOSE There is little empirical translation of multimodal cognitive activity programs in " real-world " community-based setting s. This study sought to demonstrate in a short-term pilot r and omized trial that such an activity program improves components of cognition critical to independent function among sedentary older adults at greatest risk . DESIGN AND METHODS We r and omized 149 older adults to Experience Corps ( EC ) or a wait-list control arm .  Participants r and omized to EC trained in teams to help elementary school children with reading achievement , library support , and classroom behavior for 15 hr/week during an academic year . We compared baseline and follow-up assessment s of memory , executive function ( EF ) , and psychomotor speed at 4 to 8 months by intervention arm , adjusting for exposure duration . We observed a range of EF abilities at baseline and stratified analyses according to the presence of baseline impairment using established norms . RESULTS Overall , EC participants tended to show improvements in EF and memory relative to matched controls ( ps < .10 ) . EC participants with impaired baseline EF showed the greatest improvements , between 44 % and 51 % in EF and memory at follow-up , compared to declines among impaired-EF controls ( ps < .05 ) . IMPLICATION S Short-term participation in this community-based program design ed to increase cognitive and physical activity in a social , real-world setting may train memory and , particularly , executive functions important to functional independence . This community-based program represents one potentially effective model to bring high doses of sustainable cognitive exercise to the greatest proportion of older adults , particularly those sedentary individuals at elevated risk for health disparities BACKGROUND Cognitive impairment is an important contributor to disability . Limited clinical trial evidence exists regarding the impact of physical exercise on cognitive function ( CF ) . We report results of a pilot study to provide estimates of the relative impact of physical activity ( PA ) on 1-year changes in cognitive outcomes and to characterize relationships between changes in mobility disability and changes in cognition in older adults at increased risk for disability . METHODS Sedentary persons ( 102 ) at increased risk for disability ( aged 70 - 89 years ) were r and omized to moderate-intensity PA or health education .  Participants were administered the  Digit Symbol Substitution Test ( DSST ) , Rey Auditory Verbal Learning Test ( RAVLT ) , modified Stroop test , and Modified Mini-Mental State Examination  at baseline and 1 year . RESULTS Group differences were not significant but improvements in cognitive scores were associated with improvements in physical function . Specifically , the DSST significantly correlated with change in the Short Physical Performance Battery score ( r = .38 , p = .0002 ) , in chair st and score ( r = .26 , p = .012 ) , in balance score ( r = .21 , p = .046 ) , and in 400-m gait speed ( r = .15 , p = .147 ) . Change recall on the RAVLT and in the Stroop test was also positively correlated with changes in chair st and and balance , respectively . CONCLUSIONS These results provide further support for the benefits of exercise on CF in older adults . An adequately powered clinical trial of PA involving older adults at increased risk for cognitive disability is needed to exp and the indications for prescribing exercise for prevention of decline in brain function Context : Elderly have increased risk for cognitive impairment and dementia .  Yoga therapy may be helpful in elderly to improve cognitive function  . Aims : We examined the benefits of yoga-based intervention compared with waitlist control group on cognitive function in the residents of elderly homes . Setting s and Design : Single blind controlled study with block r and omization of elderly homes . Material s and Methods : Study sample included yoga group ( n=62 ) and waitlist group ( n=58 ) . A total of 87 subjects ( yoga=44 , waitlist=43 ) completed the study period of 6 months . Yoga group received daily yoga sessions for 1 month , weekly until 3rd month and encouraged to continue unsupervised until 6 months . They were assessed on Rey 's Auditory Verbal Learning Test ( RAVLT ) , Rey 's complex figure test ( CFT ) , Wechsler 's Memory Scale (WMS)-digit and spatial span , Controlled Oral Word Association ( COWA ) test , Stroop Color Word Interference Test and Trail Making Test A and B at baseline and at the end of 6th month . Statistical Analysis : Paired t-test and analysis of covariance ( ANCOVA ) to compare the difference in neuropsychological test scores . Results : Yoga group showed significant improvement in immediate and delayed recall of verbal ( RAVLT ) and visual memory ( CFT ) , attention and working memory ( WMS-spatial span ) , verbal fluency ( COWA ) , executive function ( Stroop interference ) and processing speed ( Trail Making Test-A ) than waitlist group at the end of 6 months after correcting for corresponding baseline score and education . Conclusion : Yoga based-intervention appears beneficial to improve several domains of cognitive function in elderly living in residential care homes . Study findings need to be interpreted after considering method ological limitations like lack of active comparison group
Activities running in community-based- setting s offer a method of delivering multimodal interventions to older adults beyond cognitive training programmes .
This systematic review and meta- analysis investigated the impact of r and omised controlled trials ( RCTs ) of ' real-world ' interventions on the cognitive abilities of healthy older adults .