Physical Activity and Cognitive Function Among Mild Cognitive Impairment Community-Dwelling Elderly Adults: The Transtheoretical Model

Sunday, 30 July 2017

Tzu-Ting Huang, PhD, RN
School of Nursing, Chang Gung University, Tao-Yuan, Taiwan
Ying-Fang Huang, MSN, RN
Department of medical intensive care unit II, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan

Background: Mild cognitive impairment (MCI) is a common clinical syndrome that identifies people at high risk of developing dementia, and the prevalence range from 7.7 to 51.7%. Although treatments for MCI are currently unavailable, preliminary evidence has identified potential neuro-protective effects of physical activity (PA), which may lead to improved outcomes. However, the design and delivery of an appropriate programme for people with MCI is challenging for having physical, psychological, cognitive, and social barriers.

Purpose:  The purposes of this study are to develop and examine physical activity program, on primary outcomes (cognitive function & IADL), and secondary outcomes (physical fitness, QOL, social support and depression) among community-dwelling elderly adults with MCI.

Methods:  We developed a PA stage-matched intervention (SMI) base on the Transtheoretical Model of Change (TMC), literature and our previous findings, then, 81 elderly adults with MCI were recruited in to a 2-group pretest-posttest randomized controlled trial for 6 months and a 6-month follow-up to examine its effectiveness among community-dwelling elderly with MCI. The 24-week SMI consist of three components: (a) the stage-matched counseling strategies base on main constructs derived from the TMC; (b) exercise behavior training: we provided a 24-week, 2 times group-based (8-12 participants with 2 instructors at community centers, 60’ each) and one home-based (with the PA program VCD and manual to bring home, 30’); and (c) telephone counseling each week.

Results:  After this 24-week PA SMI, the PA group participants showed significantly better MMSE than those in the comparison group (t=2.585, p=.012); however, Mixed model analysis showed significantly on group effect only (F=8.846; p=.004). Also, the PA participants demonstrated significantly better mobility (interaction effects F=5.325; p=.024).

Conclusion:  A 24-week PA SMI could improve cognitive and mobility ability among MCI elderly adults. However, more participants and physical activity other non-pharmacological interventions (such as cognitive training) may boost the effects on cognitive function among MCI elderly.