Synergic trial secondary outcomes results on gait and falls

TL;DR

Combining exercise and cognitive training improves walking and reduces falls in older adults with mild cognitive impairment, while vitamin D does not help.

Contribution

The study reveals that combining aerobic-resistance exercise with cognitive training is most effective for improving gait and reducing falls in older adults with MCI.

Findings

Exercise-based interventions improved gait speed by 7.5 cm/s and reduced injurious falls by 62%.

Adding cognitive training to exercise showed the greatest gains in gait speed and reduced injurious falls by 87%.

Vitamin D supplementation did not improve outcomes and increased gait instability.

Abstract

Older adults with Mild Cognitive Impairment (MCI) have higher risk of gait impairments and falls, yet the effects of multimodal interventions, including combinations of exercises with cognitive training, on improving their mobility remain unclear.

To investigate the synergistic effects of aerobic-resistance exercise combined with cognitive training, with or without vitamin D supplementation, on gait performance and fall risk in older adults with Mild Cognitive Impairment (MCI).

The effect of 20 weeks of aerobic-resistance exercise, cognitive training, and vitamin D supplementation (10,000 IU 3x/week) on gait and falls in older adults with MCI was evaluated in the SYNERGIC Trial, using a fractional factorial design.

Among 161 participants, exercise-based arms (n = 4) improved gait speed (+7.5 cm/s, p < 0.001) and reduced injurious falls by 62% (IRR=0.38, p = 0.04). Exercise plus cognitive training showed the greatest gains in gait speed and reduced injurious falls (IRR=0.13, p = 0.05). Vitamin D did not enhance outcomes and increased gait instability.

Aerobic-resistance exercise combined with cognitive training improves gait performance and decreases the risk of injurious falls in older adults with MCI. The addition of vitamin D did not produce benefits.