Peer-supported exercise intervention for persons with mild cognitive impairment: A waitlist randomised controlled trial (the BRAin Vitality Enhancement trial)

Abstract

Background: motivating older people with cognitive impairment to remain physically active is challenging. Objective: this study aimed to examine the effects of a peer-supported exercise intervention on the cognitive function and health-related quality of life (HRQoL) of persons with mild cognitive impairment (MCI). Design: a two-arm randomised controlled trial. Setting and participants: community-dwelling persons with MCI were recruited from community centres for older adults in Hong Kong. Methods: participants randomised to the intervention group received an 8-week group-based peer-supported multicomponent exercise intervention, while the waitlist control group received usual care. A battery of neuropsychological tests and the Short Form-36 were administered at baseline, immediately post-intervention and 3 months post-intervention. Results: two hundred and twenty-nine participants were randomised to the intervention (n = 116) or control (n = 113) group. Compared with the control group, participants in the intervention group showed significantly greater improvements in processing speed and attention measured by the Colour Trails Test 1 (β = 7.213, 95% confidence interval [CI] = 2.870-11.557, P = 0.001) and working memory measured by the Digit Span Backward Test (β = 0.540, 95% CI = 0.199-0.881, P = 0.002) immediately post-intervention. The effects were sustained at 3 months post-intervention. Similarly, significantly greater improvements in sequencing and mental flexibility measured by the Colour Trails Test 2 were observed in the intervention group 3 months post-intervention (β = 6.979, 95% CI = 3.375-10.584, P < 0.001). Changes in global cognition, short-term memory and HRQoL were not significant. Conclusion: the peer-supported exercise intervention was effective at sustaining improvements in executive function, attention and working memory in persons with MCI.