This may be the best exercise to treat mild cognitive impairment that may lead to Alzheimer’s Dementia, according to a new study.
In 2021, dementia affected more than 50 million people worldwide, with associated costs exceeding $800 billion US dollars. Despite the absence of a cure, the strategy for addressing this condition has significantly evolved.
The spotlight is now on proactively identifying at-risk individuals and adopting non-drug and lifestyle-oriented interventions designed to bolster cognitive functions and possibly delay dementia onset.
Mild cognitive impairment (MCI) often acts as an intermediate phase between normal cognitive aging and early dementia, providing a strategic window for introducing preventive measures and early treatments.
Both aerobic and resistance exercises have individually been linked to enhanced cognitive capabilities in the elderly through various studies. Nonetheless, the potential combined benefits of these exercise modalities remain under investigation.
Similarly, digital cognitive training has shown promising results in boosting cognition among older adults by offering adaptive and mentally stimulating tasks.
Furthermore, vitamin D supplementation has been touted as a potential adjunct to exercise and cognitive training due to its neuroprotective attributes.
Consequently, applying these interventions as a comprehensive treatment could potentially decelerate the transition from MCI to dementia.
Former multidomain intervention trials on healthy elderly individuals, like the FINGER trial, have been successful in boosting cognition. Likewise, retrospective analyses of specific high-risk groups in trials such as MAPT and PREDIVA have reported positive outcomes.
However, the efficacy of multidomain interventions in populations with cognitive impairments is less certain. For instance, the recent MEDEX trial failed to show cognitive improvement when combining mindfulness training with exercise in older adults with subjective cognitive concerns.
Mixed results have been observed in MCI populations where exercise is combined with other interventions. Remarkably, two former randomized factorial trials suggested that integrating exercise with cognitive training was not as effective as exercise alone for cognitive enhancement. The sustainability of cognitive improvements post-intervention is also yet to be confirmed.
To clarify these ambiguities, the SYNERGIC Trial was launched to assess the cognitive benefits of a multidomain intervention composed of aerobic-resistance exercises, computer-based cognitive training, and vitamin D supplementation in older adults with MCI.
Known as the SYNERGIC Study, this randomized, double-masked, fractional factorial trial was conducted across various locations. It examined the effects of aerobic resistance exercise, computerized cognitive training, and vitamin D supplementation on cognition.
Participants aged 65 to 84 years with MCI were enrolled between September 2016 and April 2020. Data analysis was performed from February 2021 to December 2022.
The participants were divided into five groups and treated for 20 weeks. The first group received the full multidomain intervention, the other four received different combinations of the interventions and placebo treatments. A high-dose vitamin D regimen was also administered three times weekly.
Of the 175 randomized participants, 144 completed the intervention, and 133 finished the 12-month follow-up. At the 6-month milestone, all intervention groups involving aerobic-resistance exercise displayed improved ADAS-Cog-13 scores compared to the control group. However, vitamin D supplementation did not result in significant improvements.
In the end, the multidomain intervention led to significant improvements in ADAS-Cog-13 scores compared to the control group, although the changes in ADAS-Cog-Plus scores were not statistically significant.
In summary, the trial indicated that a multidomain intervention involving aerobic-resistance exercises and sequential computer-based cognitive training significantly improved cognition among older adults with MCI. However, the results were inconsistent, and vitamin D supplementation did not exhibit any effect.
These results suggest that a multidomain intervention of aerobic-resistance exercises combined with cognitive training could potentially enhance cognition and delay dementia onset in individuals with MCI.
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