Supporting Data for Effects of Combined Multimodal Exercise and Cognitive Training on Cognitive, Psychological, Functional and Health-Related Quality of Life Outcomes in Older Adults with Mild Dementia
Persons with dementia (PwD) experience cognitive decline and neuropsychiatric symptoms (NPS), resulting in impaired activities of daily living and reduced health-related quality of life (HRQoL). Given the limitations of drug therapies, non-pharmacological interventions remain the treatment of choice. Previous research has shown the benefits of exercise and cognitive interventions for PwD. However, whether there are synergistic effects for combined exercise and cognitive interventions in this population are unclear.
A systematic review and network meta-analysis was conducted to examine the effects of combined exercise and cognitive interventions for PwD and to identify the most effective designs. The review included 29 randomized controlled trials (RCTs) involving persons with mild cognitive impairment (MCI) and dementia to broaden its scope. Results showed that combined interventions were more effective than exercise alone but comparable with cognitive interventions alone among the population with MCI and dementia. Multimodal exercise combined with cognitive training was most effective in improving global cognition. This review further revealed limited studies focused on persons with mild dementia, who still retain the ability to engage meaningfully in interventions. Based on these findings, a 12-week caregiver-assisted combined multimodal exercise and cognitive training (CA-MECT) intervention was developed. This intervention comprised online training implemented through videoconferencing and supplemented with home visits and caregiver-assisted home-based training. A pilot study demonstrated its feasibility, acceptability, and preliminary effects in older adults with mild dementia.
The main study adopted a sequential mixed-methods design, including a single-blind, parallel-group RCT and a qualitative study. Seventy-two participants were recruited and randomly assigned to either the CA-MECT intervention (n = 36) or control group (n = 36). Validated instruments were used to evaluate global cognition, cognitive domains, NPS, instrumental activities of daily living (IADLs), and HRQoL at baseline (T0), immediately post-intervention (T1), and three months later (T2). Semi-structured qualitative interviews were conducted to explore participant-caregiver engagement experience and perceived benefits.
This study will help to explore an effective non-drug intervention to slow down cognitive decline among persons with mild dementia.
