Effects of combined digital inclusion and physical activity intervention on the cognition of older adults in Brazil

Background: Cognitive decline in normal aging is a major concern in aging societies as it impacts independence in daily life, quality of life and life expectancy.Population aging in the coming decades makes the prevention of cognitive decline and maintenance of functional capacity, important public health issues due to the social impact and economic costs of the demographic process.Objective: Research aims to evaluate the effectiveness of combined digital inclusion and physical activity interventions in the prevention of cognitive and functional loss among elderly residents in a large urban center in Brazil.The study is a comparative controlled study in primary care setting.Methods: We sampled 112 individuals from a population cohort of adults ages 60 and older, previously evaluated by Clinical Dementia Rating scale (zero and 0.5 scores), without depressive symptoms allocated to intervention group (IG) and control group (CG).IG participants attended a computer-based digital inclusion program combined with physical activity, with 80-min sessions twice a week for 17 weeks, whereas the CG followed their daily routine.We administered neuropsychological tests to all participants at baseline and follow-up (Montreal Cognitive Assessment -MoCA, Mini-Mental Status Exam -MMSE, list of words, verbal fluency, and animal categories), plus an evaluation of independence in activities of daily living -ADL and the Geriatric Depression Scale -GDS.Results: An intention-to-treat analysis showed an average increase of 1.23 points in MoCA scores after the intervention (p=0.012).Secondary analysis considering the number of sessions attended showed that MoCA scores increased 0.074 points on average for each session attended (p<0.001) and MMSE scores increased 0.029 points on average for each session attended (p<0.022).There were no statistical differences post-intervention for the other variables.Conclusions: The intervention improved global cognition among elderly residents.The results did not show improvements in specific cognitive domains or independence in daily life.We recommend longer and more powerful studies statistically to further assess the impact of this strategy in the prevention of functional and cognitive loss.