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Zhou Y, Miao XM, Zhou KL, Yu CJ, Lu P, Lu Y, Zhao J. Effects of exercise-cognitive dual-task training on elderly patients with cognitive frailty and depression. World J Psychiatry 2025; 15:103827. [DOI: 10.5498/wjp.v15.i4.103827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2024] [Revised: 01/20/2025] [Accepted: 02/21/2025] [Indexed: 03/25/2025] Open
Abstract
BACKGROUND Cognitive frailty and depression are prevalent among the elderly, significantly impairing physical and cognitive functions, psychological well-being, and quality of life. Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.
AIM To evaluate the effects of exercise-cognitive dual-task training on frailty, cognitive function, psychological status, and quality of life in elderly patients with cognitive frailty and depression.
METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023. Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care. Frailty, cognitive function, balance and gait, psychological status, and quality of life were assessed before and after the intervention.
RESULTS After the intervention, the frailty score of the observation group was (5.32 ± 0.69), lower than that of the control group (5.71 ± 0.55). The Montreal cognitive assessment basic scale score in the observation group was (24.06 ± 0.99), higher than the control group (23.43 ± 1.40). The performance oriented mobility assessment score in the observation group was (21.81 ± 1.24), higher than the control group (21.15 ± 1.26). The self-efficacy in the observation group was (28.27 ± 2.66), higher than the control group (30.05 ± 2.66). The anxiety score in the hospital anxiety and depression scale (HADS) for the observation group was (5.86 ± 0.68), lower than the control group (6.21 ± 0.64). The depression score in the HADS for the observation group was (5.67 ± 0.75), lower than the control group (6.27 ± 0.92). Additionally, the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group, with statistically significant differences (P < 0.05).
CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty, enhancing cognitive function, and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.
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Affiliation(s)
- Ying Zhou
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
- Department of Nursing, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Xiao-Ming Miao
- Acupuncture and Rehabilitation Center, Tongxiang Hospital of Traditional Chinese Medicine, Tongxiang 314599, Zhejiang Province, China
| | - Kai-Lian Zhou
- Department of Nursing, The First Affiliated Hospital of Jiaxing University, Jiaxing 314299, Zhejiang Province, China
| | - Cheng-Ji Yu
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
- Department of Nursing, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Ping Lu
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
- Department of Nursing, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Yin Lu
- Department of Rehabilitation, Affiliated Rehabilitation Hospital of Tongxiang Health School, Tongxiang 314599, Zhejiang Province, China
| | - Juan Zhao
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
- Department of Nursing, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
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Sung PS, Lee D. Impact of Visual Input and Kinesiophobia on Postural Control and Quality of Life in Older Adults During One-Leg Standing Tasks. Vision (Basel) 2025; 9:24. [PMID: 40137936 DOI: 10.3390/vision9010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2025] [Revised: 03/10/2025] [Accepted: 03/18/2025] [Indexed: 03/29/2025] Open
Abstract
Visual conditions significantly influence fear of movement (FOM), which is a condition that impairs postural control and quality of life (QOL). This study examined how visual conditions influence sway velocity during repeated one-leg standing tasks and explored the potential relationship between postural control, FOM, and QOL in older adults with and without FOM. Thirty-seven older adults with FOM and 37 controls participated in the study. Postural sway velocity was measured across three repeated trials under visual conditions in both anteroposterior (AP) and mediolateral (ML) directions. The groups demonstrated significant interaction under visual conditions (F = 7.43, p = 0.01). In the eyes-closed condition, the FOM group exhibited faster ML sway velocity than the control group, with significant differences across all three trials. There was a significant interaction between sway direction and vision (F = 27.41, p = 0.001). In addition, the FOM demonstrated strong negative correlations with several QOL measures on social functioning (r = -0.69, p = 0.001) and role limitations due to emotional problems (r = -0.58, p = 0.001) in the FOM group. While FOM influenced sway velocity during balance tasks, visual input emerged as a key determinant of postural control. The FOM group demonstrated a heightened reliance on vision, suggesting an increased need for vision-dependent strategies to maintain balance.
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Affiliation(s)
- Paul S Sung
- School of Nursing and Health Professions, Department of Physical Therapy, Indiana Wesleyan University, Marion, IN 46953, USA
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Kuo FL, Liao ZY, Liao PC, Wang HH. Impact of community-based precision functional training on older adults' walking and cognitive abilities in rural Taiwan: a pre-posttest study. BMC Geriatr 2024; 24:819. [PMID: 39394100 PMCID: PMC11468099 DOI: 10.1186/s12877-024-05422-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 09/30/2024] [Indexed: 10/13/2024] Open
Abstract
BACKGROUND Functional training is essential for maintaining the independence of older adults, especially in rural areas with limited resources. In this study, we assess the short-term and long-term impacts of the Precision Functional Training (PFT) program on mobility outcomes, specifically walking performance, and cognitive ability in community-dwelling older adults. The unique feature of this training program was its countywide, community-based, and tailored approach, designed to strengthen the functional abilities of older adults living in rural areas. METHODS 158 older adults aged 65 years and above were assessed in this one-group pre-posttest study conducted in 11 community care stations in Chiayi County, Taiwan. Participants had two follow-ups, with data collection on mobility and cognition. The 12-week PFT program, led by certified trainers, integrated aerobic, strength, and cognitive elements. Primary outcomes, including changes in gait, falls, and cognition, were analyzed using linear mixed effects and logit models. RESULTS Strengthening mobility is critical to slowing functional decline in older adults. The PFT program led to significant improvements in cognitive function and several gait parameters compared with the baseline. Participants with limited mobility showed enhanced activities of daily living 1-month post-training, but these gains did not persist at the 1-year mark. No significant differences were observed in fall occurrence and knee extension strength. CONCLUSIONS The training did not have a long-term effect; thus, more frequent practice may be necessary. Risk assessment and community-based interventions, particularly for older adults with a higher risk of falls, are recommended. Future prospective randomized controlled trials are needed to evaluate the PFT program's effectiveness in preserving mobility.
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Affiliation(s)
- Fang-Lin Kuo
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, 8, Xuefu W. Rd., Huwei Township, Yunlin County, 63247, Taiwan.
| | - Zih-Yong Liao
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, 8, Xuefu W. Rd., Huwei Township, Yunlin County, 63247, Taiwan
| | - Pei-Chun Liao
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, 8, Xuefu W. Rd., Huwei Township, Yunlin County, 63247, Taiwan
| | - Hsiu-Hua Wang
- Department of Athletic Sports, National Chung Cheng University, Chiayi County, Taiwan
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Trombini-Souza F, de Moura VTG, da Silva LWN, Leal IDS, Nascimento CA, Silva PST, Perracini MR, Sacco ICN, de Araújo RC, Nascimento MDM. Effects of two different dual-task training protocols on gait, balance, and cognitive function in community-dwelling older adults: a 24-week randomized controlled trial. PeerJ 2023; 11:e15030. [PMID: 37101796 PMCID: PMC10124542 DOI: 10.7717/peerj.15030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/19/2023] [Indexed: 04/28/2023] Open
Abstract
Background Although alternating dual-task (ADT) training is functionally easier for older adults, a large part of the motor and cognitive tasks is simultaneously performed, especially during activities of daily living that require maintaining body balance. Objective To evaluate the effects of mixed dual-task training on mobility, cognitive function, and balance in community-dwelling older adults. Methods Sixty participants were randomly allocated at a 1:1 ratio into the experimental group-single motor task (SMT) and simultaneous dual task (SDT) interchangeably in stage 1 (for 12 weeks) and after strictly with SDT in stage 2 (the last 12 weeks)-or into the control group-only SMT and SDT interchangeably in stages 1 and 2. Gait parameters were acquired by two inertial sensors. Physical and cognitive performance were acquired by specific questionnaires. Generalized linear mixed models were used for analyzing interaction and main effects. Results No between-group difference was observed for gait performance. Both protocols improved mobility (mean change ((MC) = 0.74)), dual-task effect (MC = -13.50), lower limb function (MC = 4.44), static (MC = -0.61), and dynamic balance (MC = -0.23), body sway (MC = 4.80), and cognitive function (MC = 41.69). Conclusion Both dual-task training protocols improved these outcomes.
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Affiliation(s)
- Francis Trombini-Souza
- Department of Physical Therapy, University of Pernambuco, Petrolina, Pernambuco, Brazil
- Master’s and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, Pernambuco, Brazil
| | | | | | - Iara dos Santos Leal
- Department of Physical Therapy, University of Pernambuco, Petrolina, Pernambuco, Brazil
- Master’s and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, Pernambuco, Brazil
| | | | | | - Monica Rodrigues Perracini
- Master’s and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Isabel CN Sacco
- School of Medicine, Department of Physical Therapy, Universidade de São Paulo, São Paulo, Brazil
| | - Rodrigo Cappato de Araújo
- Department of Physical Therapy, University of Pernambuco, Petrolina, Pernambuco, Brazil
- Master’s and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, Pernambuco, Brazil
| | - Marcelo de Maio Nascimento
- Department of Physical Education, Federal University of São Francisco Valley, Petrolina, Pernambuco, Brazil
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Trombini-Souza F, Nogueira RTDSA, Serafim ACB, Lima TMMD, Xavier MKA, Perracini MR, de Araújo RC, Sacco ICN, Nascimento MDM. Concern About Falling, Confidence in Balance, Quality of Life, and Depression Symptoms in Community-Dwelling Older Adults After a 24-week Dual-Task Training With Variable and Fixed Priority: A Randomized Controlled Trial. Res Aging 2022; 44:658-668. [DOI: 10.1177/01640275221073993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective To evaluate the effect of a 24-week dual-task training with progression from variable to fixed priority on the concern about falling, confidence in balance, quality of life, and depression symptoms in community-dwelling older adults. Methods A total of 60 participants (60–80 y.o.) were randomly allocated into a dual-task training group with progression from variable to fixed priority (experimental group) or into a dual-task training group with variable priority (control group). Results No between-group difference was observed after the intervention. A significant time effect showed a reduction in concern about falling [mean difference (MD) = -2.91)] and depression symptoms (MD = −1.66), an increase in the physical function (MD = 7.86), overall mental health (MD = 5.82), perception of vitality, energy, and less fatigue (MD = 10.45), general perception of overall health (MD = 6.81), and their health compared to the last year (MD = 11.89). Conclusion The experimental protocol was not superior to the control one. However, both protocols improved these outcomes.
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Affiliation(s)
- Francis Trombini-Souza
- Department of Physical Therapy, University of Pernambuco, Brazil
- Master’s and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Brazil
| | | | | | | | | | | | - Rodrigo Cappato de Araújo
- Department of Physical Therapy, University of Pernambuco, Brazil
- Master’s and Doctoral Programs in Rehabilitation and Functional Performance, University of Pernambuco, Brazil
| | - Isabel CN Sacco
- School of Medicine, Physical Therapy, Speech and Occupational Therapy Department, Universidade de Sao Paulo, Brazil
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