Effectiveness of Combined Cognitive and Physical Interventions to Enhance Functioning in Older Adults With Mild Cognitive Impairment: A Systematic Review of Randomized Controlled Trials

Abstract Background and Objectives Cognitive training delivered in conjunction with physical activity, may help to optimize aging and delay or prevent dementia in individuals with mild cognitive impairment (MCI). However, their efficacy is less well studied compared to pharmaceutical treatments. This systematic review synthesizes the emerging evidence on combined cognitive-physical interventions for enhancing functioning in older adults with MCI, with implications for practice and research. Research Design and Methods We searched the PubMed, PsycINFO, Ageline, Medline, Web of Science and ProQuest databases, and hand-searched articles published between July 2013 and November 2018. Only randomized controlled trials which incorporated cognitive and physical components targeted to individuals with MCI over the age of 50 were eligible. Our search yielded 10 eligible, independent articles. Results Intervention participants with MCI self-reported, or demonstrated, improved functioning across a range of cognitive (global cognitive function, executive function, processing speed, memory, attention, mood, emotion, motivation, brain cortex, orientation), and physical (gait, balance, mobility) outcomes. Interventions which combined cognitive-physical training were comparable to those which isolated these same elements, in terms of their effects on executive function, processing speed, attention, mood, and cardiorespiratory fitness. Discussion and Implications There is preliminary evidence to support the positive effects of multicomponent interventions to improve cognitive-motor abilities in older adults at risk of developing dementia. The strength of this research evidence is, however, limited. Longitudinal studies are needed to determine whether these effects are maintained over time. The optimal intervention intensity and length also need to be established.