The Mental Activity and eXercise (MAX) trial: Effects on physical function and quality of life among older adults with cognitive complaints |
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| Affiliation: | 1. Department of Kinesiology, University of Waterloo, Canada;2. Department of Epidemiology and Biostatistics, University of California San Francisco, USA;3. Benioff Children''s Hospital, University of California San Francisco, USA;4. Department of Clinical Psychology, Notre Dame de Namur University, USA;5. Department of Psychiatry, University of California San Francisco, USA;6. Department of Psychiatry, San Francisco Veterans Affairs Medical Centre, USA;7. Department of Medicine, University of California San Francisco, USA;8. Department of Neurology, University of California San Francisco, USA;1. Department of Epidemiology and Preventive Medicine, Monash University, Level 5, 99 Commercial Rd, Melbourne 3004, Australia;2. Monash Ageing Research Centre (MONARC), Monash University, The Kingston Centre, Warrigal Rd, Cheltenham 3192, Australia;3. Department of Neuroscience (Medicine), Monash University, The Alfred Hospital, Commercial Rd, Melbourne 3004, Australia;4. Department of Lung and Sleep Medicine, Monash Health, 246 Clayton Rd, Clayton, Vic 3168, Australia;5. School of Clinical Sciences, Monash University, 246 Clayton Rd, Clayton, Vic 3168, Australia;6. Department of Vision Informatics (Topcon),Osaka University Graduate School of Medicine, E7 2-2 Yamada-oka, Suita-city, Osaka 565-1871, Japan;7. Centre for Advanced Imaging, University of Queensland, Building 57, Research Rd, The University of Queensland, St Lucia, QLD 4072, Australia;8. The Department of Allergy, Immunology & Respiratory Medicine, Alfred Hospital, The Central Clinical School, Monash University, Commercial Rd, Melbourne, VIC 3004, Australia;9. Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC 3084, Australia;10. Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Vic, Australia;11. Singapore Eye Research Institute, Singapore National Eye Center, 11 Third Hospital Avenue, 168751, Singapore;12. Duke-NUS Medical School, National University of Singapore, 8 College Rd, 169857, Singapore;13. School of Public Health, Curtin University, Kent St, Bentley, Perth, WA 6102, Australia;14. College of Medicine, Biology and Environment, Australian National University, Building 4, The Canberra Hospital, Hospital Rd, Garran ACT, Canberra 2605, Australia;15. Discipline of General Practice, Adelaide Medical School, University of Adelaide, Corner of North Terrace and George St, Adelaide, SA 5000, Australia;p. Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Department of Surgery (Opthalmology), University of Melbourne, 32 Gisborne St, East Melbourne, VIC 3002, Australia;q. The ASPREE Study Group, Australia, USA;1. Department of Psychiatry (LR, AB), University of California, San Francisco, CA;2. Northern California Institute for Research and Education (FX), San Francisco, CA;3. Division of Cardiology, Department of Medicine (JO), University of California, San Francisco, CA;4. Departments of Psychiatry, Neurology, and Epidemiology (KY), University of California, San Francisco VA Medical Center, San Francisco, CA;1. Penn State College of Medicine, United States;2. Penn State University, United States;3. University of Pittsburgh, United States;4. Columbia University, United States;5. University of Utah, United States;6. Johns Hopkins University, United States;7. University of Illinois, United States;8. Temple University, United States;9. Einstein Medical Center, United States |
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| Abstract: | BackgroundOlder adults with cognitive complaints are vulnerable to dementia, physical impairments, and poor quality of life. Exercise and mental activity may improve physical function and health-related quality of life (HRQOL) but combinations have not been investigated systematically. The Mental Activity and eXercise (MAX) trial found that mental activity plus exercise over 12 weeks improved cognitive function (primary outcome) in sedentary older adults with cognitive complaints.ObjectiveTo investigate the effects of combinations of two mental activity and exercise programs on physical function and HRQOL (secondary outcomes).MethodsParticipants (n = 126, age 73 ± 6 years, 65% women) were randomized to 12 weeks of exercise (aerobic exercise or stretching/toning, 3 × 60 min/week) plus mental activity (computer-based cognitive training or educational DVDs, 3 × 60 min/week) using a factorial design. Assessments included the Senior Fitness Test (physical function), Short Form-12 physical and mental sub-scales (HRQOL), and CHAMPS questionnaire (physical activity).ResultsThere were no differences between groups at baseline (p > 0.05). We observed improvements over time in most physical function measures [chair stands (p-for-time = 0.001), arm curls (p-for-time < 0.001), step test (p-for-time = 0.003), sit & reach (p-for-time = 0.01), and back scratch (p-for-time = 0.04)] and in physical HRQOL (p-for-time = 0.04). There were no differences in change between groups (group 1 time p > 0.05). Changes in most physical function measures and physical HRQOL correlated with physical activity changes.ConclusionCombined mental activity and exercise interventions of various types can improve both physical function and physical HRQOL among sedentary older adults with cognitive complaints. Exercise control group design should be carefully considered as even light exercise may induce benefits in vulnerable older adults. |
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