Can dual-task high-velocity exercise training improve cognitive function in older adults? Secondary analysis of an 18-month cluster randomized controlled trial.

DT-FPT produced significant net benefits in choice reaction time, attention, and psychomotor-attention after the 6-month supervised phase compared to usual care control.

• Net benefit in choice reaction time and attention was 0.17 SD (P = 0.016) in DT-FPT vs CON after the 6-month supervised phase.
• Net benefit in psychomotor-attention composite was 0.19 SD (P = 0.029) after the 6-month supervised phase.
• A composite of psychomotor-attention and learning-working memory showed a net benefit of 0.11 SD (P = 0.046) after 6 months.
• The study randomized 300 residents aged ≥65 years from 22 independent-living retirement communities to DT-FPT or usual care control (CON).

Benefits from DT-FPT relative to CON extended to visual learning and learning-working memory at 12 and 18 months.

• Visual learning showed a net benefit of 0.29 SD (P = 0.013) at 12 months and 0.27 SD (P = 0.008) at 18 months in DT-FPT vs CON.
• Learning-working memory showed a net benefit of 0.13 SD (P = 0.047) at 12 months and 0.18 SD (P = 0.013) at 18 months in DT-FPT vs CON.
• These benefits persisted into the 6-month follow-up period (i.e., 18-month timepoint) after the 12-month active intervention phase.

The usual care control group exhibited a net benefit for executive function at 18 months relative to DT-FPT.

• CON exhibited a 0.19 SD net benefit for executive function (P = 0.003) after 18 months compared to DT-FPT.
• This finding suggests that DT-FPT did not improve, and may have relatively disadvantaged, executive function compared to control over the full 18-month period.

BDNF Met carriers in the DT-FPT group showed improved working memory and learning-working memory compared to CON at 18 months.

• BDNF Met carriers in DT-FPT showed improved working memory of 0.35 SD (P = 0.042) versus CON at 18 months.
• BDNF Met carriers in DT-FPT showed improved learning-working memory of 0.37 SD (P = 0.011) versus CON at 18 months.
• BDNF and APOE polymorphism data were obtained from blood samples, suggesting genotype may influence cognitive responses to DT-FPT.

The DT-FPT intervention was a group-based program lasting 12 months with a subsequent 6-month follow-up, combining high-velocity power training with simultaneous cognitive and/or motor tasks.

• The intervention consisted of 6 months supervised DT-FPT followed by 6 months maintenance phase, performed 2 times per week for 45–60 minutes per session.
• The program was conducted simultaneously with cognitive and/or motor tasks (dual-task functional power training).
• Twenty-two independent-living retirement communities were cluster-randomized, with 300 residents aged ≥65 years at increased falls risk enrolled.
• Cognitive domains were assessed using CogState at baseline, 6, 12, and 18 months, with z-scores used to create composite scores for psychomotor-attention, learning-working memory, and global cognition.

Overall exercise adherence was moderate, with 50% adherence at 6 months and 40% at 12 months, and 74% of participants completed the 18-month intervention.

• Mean exercise adherence was 50% at the 6-month supervised phase and 40% at the 12-month maintenance phase.
• 223 out of 300 participants (74%) completed the 18-month intervention.
• Low adherence may have limited the magnitude of cognitive benefits observed.