Effects of a Cognitive Training With and Without Additional Physical Activity in Healthy Older Adults: A Follow-Up 1 Year After a Randomized Controlled Trial

Elke Kalbe; Mandy Roheger; Kay Paluszak; Julia Meyer; Jutta Becker; Gereon R Fink; Juraj Kukolja; Andreas Rahn; Florian Szabados; Brunhilde Wirth; Josef Kessler

doi:10.3389/fnagi.2018.00407

Effects of a Cognitive Training With and Without Additional Physical Activity in Healthy Older Adults: A Follow-Up 1 Year After a Randomized Controlled Trial

Front Aging Neurosci. 2018 Dec 18:10:407. doi: 10.3389/fnagi.2018.00407. eCollection 2018.

Authors

Elke Kalbe¹, Mandy Roheger¹, Kay Paluszak¹, Julia Meyer², Jutta Becker³, Gereon R Fink^{4

5}, Juraj Kukolja⁶, Andreas Rahn⁷, Florian Szabados⁸, Brunhilde Wirth³, Josef Kessler⁴

Affiliations

¹ Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention, University Hospital Cologne, Cologne, Germany.
² Institute for Interdisciplinary Dermatological Prevention and Rehabilitation, Osnabrück University, Osnabrück, Germany.
³ Institute of Human Genetics, University Hospital Cologne, Cologne, Germany.
⁴ Department of Neurology, University Hospital Cologne, Cologne, Germany.
⁵ Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany.
⁶ Department of Neurology, HELIOS University Hospital Wuppertal, Wuppertal, Germany.
⁷ Department of Geriatrics, St. Franziskus-Hospital Lohne, Lohne, Germany.
⁸ Laboratory Services Laborarztpraxis Osnabrück, Osnabrück, Germany.

Abstract

Background: Combining cognitive training (CT) with physical activity (CPT) has been suggested to be most effective in maintaining cognition in healthy older adults, but data are scarce and inconsistent regarding long-term effects (follow-up; FU) and predictors of success. Objective: To investigate the 1-year FU effects of CPT versus CT and CPT plus counseling (CPT+C), and to identify predictors for CPT success at FU. Setting and Participants: We included 55 healthy older participants in the data analyses; 18 participants (CPT group) were used for the predictor analysis. Interventions: In a randomized controlled trial, participants conducted a CT, CPT, or CPT+C for 7 weeks. Outcome Measures: Overall cognition, verbal, figural, and working memory, verbal fluency, attention, planning, and visuo-construction. Results: While within-group comparisons showed cognitive improvements for all types of training, only one significant interaction Group × Time favoring CPT in comparison to CPT+C was found for overall cognition and verbal long-term memory. The most consistent predictor for CPT success (in verbal short-term memory, verbal fluency, attention) was an initial low baseline performance. Lower education predicted working memory gains. Higher levels of insulin-like growth factor 1 (IGF-1) and lower levels of brain-derived neurotrophic factor at baseline (BDNF) predicted alternating letter verbal fluency gains. Discussion: Within-group comparisons indicate that all used training types are helpful to maintain cognition. The fact that cognitive and sociodemographic data as well as nerve growth factors predict long-term benefits of CPT contributes to the understanding of the mechanisms underlying training success and may ultimately help to adapt training to individual profiles. Clinical Trial Registration: WHO ICTRP (http://apps.who.int/trialsearch/), identifier DRKS00005194.

Keywords: RCT; cognitive training; combined lifestyle intervention; follow-up; healthy older adults; neurobiological mechanisms; physical training; predictor.