Effects of Exercise Alone or Combined With Cognitive Training and Vitamin D Supplementation to Improve Cognition in Adults With Mild Cognitive Impairment

JAMA Network Open
Q1
Jul 2023
Citations:64
Influential Citations:3
Interventional (Human) Studies
93
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Enhanced Details

Methods
Design: multisite, randomized, double-masked, fractional factorial trial with 5 arms; participants: adults aged 60-85 with mild cognitive impairment; 175 randomized (mean age 73.1 years; 86 women [49%]); assessments at baseline, 6 months, and 12 months.
Intervention
Vitamin D: 10,000 IU oral capsules, three times weekly, for 20 weeks.
Results
Multidomain intervention combining aerobic-resistance exercise with sequential computerized cognitive training significantly improved cognition (ADAS-Cog-13) at 6 months versus control and versus exercise alone (approximately 2.4–2.6 point reductions; effect size around 0.7). Vitamin D supplementation did not enhance cognition. Clinically meaningful improvements (≥3 points) occurred in about 44% (arm with full multidomain), 37% (multidomain without vitamin D), versus 15% in control. Improvements persisted for some arms at 12 months; adherence was high (≈87%). Conclusion: this multidomain regimen may meaningfully improve global cognition in older adults with MCI and could delay progression to dementia; vitamin D adds no cognitive benefit.
Limitations
COVID-19-related early termination reduced power; most participants were vitamin D sufficient at baseline; sample predominantly White and highly educated, limiting generalizability; no adjustment for two primary endpoints.

Abstract

Key Points Question Does a multidomain intervention of aerobic-resistance exercises with cognitive training and vitamin D improve cognition in older adults with mild cognitive impairment? Findings In this randomized clinical trial including 175 Canad...