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

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

Cognitive abilities naturally decline with age. But there is some evidence that this decline can be slowed down by training. For example, cognitive interventions that use neuroplasticity have been shown to improve the cognitive skills of older adults. In addition, physical fitness interventions have been found to improve older adults’ cognitive skills and their physical health. This pattern of findings suggests that an intervention that combines both cognition and fitness may provide the most cognitive benefits.

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

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

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Both groups performed various physical and cognitive assessments before and after training. These measures included a wakefulness task that tested the participants’ ability to stabilize their attention from moment to moment. In addition, forty-one participants participated in a one-year follow-up.

The researchers compared participants’ performance on the attention task before and after the intervention. It turned out that participants in the BBT group showed significant improvements in attention that persisted after one year. These gains were not observed in the active control group. In addition, the BBT group outperformed a separate cohort of young adults who completed the same attention task, but without the training.

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

There was also neural evidence of improved attention in the BAT group. Electroencephalography (EEG) recordings taken during the attention task revealed that those who took part in the combined training showed midfront theta strength similar to that of young adults. This neural metric has been associated with sustained attention.

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

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

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

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

Anguera said it “would be great to follow this up with a more mechanistic trial where we test this intervention on cognitive training alone and physical fitness alone, to try and see if the possibility of synergistic effects exists beyond these control groups.” And then to see how this might play out in other populations where attentional enhancements are typically sought.

“We were quite excited to have a placebo control that matches the expectation for this study because the value of this type of control group is not really well appreciated,” he added. “So I hope more groups want to use this kind of control for their studies.”

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

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