The Effects of an Online Movement and Cognitive Dual Task Training Program for Community-Based Adults and Older Adults on Executive Function: A Pilot Study

Abstract

Objective: To examine the effects of a 30-minute, 3x/week, 24-session at home online movement and cognitive exercise program on executive function in community-based adults and older adults. Background: Cognitive performance is known to decline over time. Essential for functional independence through the aging process, cognitive performance can determine whether an individual has the ability to live independently, drive safely, and manage medications and finances. There is a growing body of evidence supporting the use of dual movement and cognitive interventions to improve executive function in the aging population. No known studies have examined the impact of an online dual movement and cognitive training program on attention, visual and auditory spatial working memory and processing speed; three essential contributors to executive function. Methods: This was a prospective pre-experimental pilot study. Participants were recruited from the greater Washington, D.C area, including those who reside in independent living facilities. Twenty-two individuals consented (age: 75.95±3.55; gender: 17F/5M) and completed the Brain and Balance (BAB) program which consisted of 24-online training sessions, spanning approximates 30 minutes each, 2-3 times per week. Outcome Measures: Administered via videoconference, baseline and post intervention measures of cognitive performance included the Deary-Liewald simple (RTS) and choice (RTC) reaction time task, the forward (DS-f) and backwards Digit Span (DS-bk), Letter Number Sequencing (LNS) and the spatial addition (SA) subset of the Wechsler Memory Scale-IV. Data Analysis: Statistical analysis was completed using STATA IC version 16 and Microsoft Excel. Normality was visually confirmed with histogram graphs. A comparison of means pre and post training was completed using a paired t-test with a significance set at level of p≤0.05. Scatter plots were used to depict individual baseline and post treatment scores for each outcome measure, the difference in scores and mean difference (meandiff). Cohen’s d unbiased was used to calculate effect size. Results: Following BAB, improvements in RTS (meandiff = -10.95ms), RTC (meandiff= -37.50ms), DS-f (meandiff = 0.54), DS-bk (meandiff = 0.57), LNS (meandiff = 0.62) were observed. Small effects were observed for DS-f (Cohen’s d (unbiased) = 0.201), DS-bk (Cohen’s d (unbiased)= 0.236), LNS (Cohen’s d (unbiased)= 0.206). RTS and RTC were treated as non-parametric data, there was a small effect for RTC with r=0.210, however RTS effect was unremarkable at r= 0.053. SA data were grouped by baseline performance (low performers ≤ 10, high performers >10). Following BAB, improvements in low performers (meandiff = 0.60) and small effect (Cohen’s d (unbiased) = 0.27) were observed. However, baseline high performers in SA task showed a moderate decline post treatment, likely attributed to a possible regression towards the mean. Conclusion: Participants trended towards improvement in cognitive performance following an online simultaneous movement and cognitive training program. Further research is necessary to determine magnitude of change and functional implications associated with dual movement and cognitive training in this population.