Research looking at ways of preventing cognitive decline in the elderly at the same time as improving their physical well being is still very new. But a study of exercise combining physical workout with executive functions is showing promising results.
“Exergaming” is a new type of exercise using interactive environments that appears to effectively improve cognitive skills in the over-50 population, according to the study, which was recently published in the American Journal of Preventive Medicine.
We’ve known about the beneficial psychological and cardiovascular effects of regular exercise for many years, but this new research suggests that exergaming could deliver even more benefits.
The combination of using executive functions alongside or integrated into cardiovascular workout may have additional benefits for cognition and could prevent moderate cognitive impairment. While the study didn’t explicitly look into the prevention of dementia (it only ran for three months), this latter finding is particularly interesting because it may have implications for dementia prevention.
A small study
The study authors tested 63 people (of the 102 who voluntered for the study) aged over 55 years from eight different retirement communities. These study participants were randomly allocated to an exercise group using a standard exercise bike (control group) or a virtual-reality-enhanced exercise bike (cybercycle group).
The virtual-reality-enhanced group was able to “compete” with a ghost cyclist on screen, which enabled them to use executive functions in an interactive way while exercising on the stationary bike.
Both groups were of similar age and fitness level before starting the program and both exercised the same amount during the research. The stationary bikes were also otherwise identical. All participants were given a target heart rate to maintain during exercise.
Over a month-long familiarisation period beforehand, the participants increased exercise to five 45-minute sessions a week so that everyone was exercising the same amount. All participants were also asked to hold other lifestyle factors (diet, other physical activities) to the same level during the study.
After this initial familiarisation period, the cybercycle participants competed with a ghost rider in a 3D virtual environment on the screen in front of them while exercising. The main outcome measured was standard neuropsychological tests of executive function (higher order cognitive functioning). Blood was also measured to look at possible underlying links between the exercise and neuroplasticity, which is the ability of the brain to heal itself by finding new connections.
What happened next?
The results showed that the cybercycle group performed significantly better on three measures of executive function:
1) The Colour Trails Test (a test timing your ability to connect colour and number dots);
2) Stroop C (a test timing your ability to name the colour of ink contrasting to a colour word); and
3) Digit span backwards (the ability to repeat a string of numbers in reverse order).
All three tests relate to executive or higher level cognitive function. Cybercyclists were also less inclined to show progressive cognitive decline reaching levels compatible with the diagnostic category of “moderate cognitive impairment during the study. This means that fewer cybercyclists were found to have a decline in cognitive function, unlike the other cyclists.
While the study results show tremendous promise, it’s important be careful of over-interpreting the results. A three-month assessment period is too short to say anything meaningful about the ability of any measure to prevent the onset of dementia, which typically occurs over a period of many years. And a larger number of participants would generally be required to claim the study shows that.
A further problem with this research is that the measures used are very specific tasks that were tested and cannot be generalised to represent an improvement in executive functioning in a more general or larger sense.
Nonetheless, this is an intriguing pilot study showing positive results that may well turn out to be important if they’re replicated in a larger group over a greater period of time.
The benefits of exercise are well documented for both physical and psychological well being. But only about one in seven adults between ages 55 and 74 years and one in 15 aged over 75 engage in regular exercise.
The use of exergaming will hopefully make exercise more enticing and may have the additional effect of improving cognition among the elderly. This study poses some intriguing questions and raises some possible mechanisms on the back of some exciting initial results for what is still a very young research field.