Developing meaningful and effective cognition-oriented treatments to enhance cognition and dementia prevention is a major public health need. This online randomized controlled trial assessed the effects of a new web-based cognitive training platform, the Breakfast Game (BG), which simulates real-life executive control/multitasking demands. Participants were randomized into 1) experimental group: BG using the Emphasis Change (EmCh), a strategy to facilitate flexible attention allocation, or 2) active control group: BG without EmCh. Thirty-eight cognitively unimpaired older adults, highly educated (mean 16.4 years) and mostly White (78%), were included in the study. Participants underwent pre- and post-assessments with 12 intervention sessions, three times per week. The intent-to-treat approach and linear-mixed models were implemented, and all models controlled for baseline performance. Both groups improved the game performance over the sessions, but the EmCh presented significantly greater improvement. There were time-by-group interactions in the game metrics and near-transfer outcomes on multitasking and executive/attention control, indicating greater training gains and transfer effects in the EmCh group. There were no distant-transfer effects on self-efficacy, mood, or cognitive activities in daily life. The BG with the EmCh is a promising online intervention tool to promote cognitive health and enhance executive control / multitasking abilities in aging.
BackgroundPhysical exercise is widely recognized for its cognitive benefits; however, the effect of menopausal status in modulating the cognitive effects of exercise is not definitively established.ObjectiveTo examine the cognitive benefits of two 6-month physical exercise programs in cognitively healthy older women across adulthood, and whether menopause status moderates these benefits.MethodsIn a post hoc analysis of a randomized controlled trial, 93 cognitively healthy women (aged 20-67; 43% at post-menopause) were assigned to either aerobic exercise (AE) or stretching/toning (ST) 4 days a week for six months. Neuropsychological assessment, cardiorespiratory exercise test, and blood draw were performed at baseline, 3-months, and 6-months. Linear mixed-effects regression models assessed whether menopausal status moderated the impact of exercise on executive functions and processing speed.ResultsSeventy-six participants (81.7%) completed the intervention. A time-by-group-by-menopause interaction emerged after 3 months (β = -0.89; p = 0.001) and 6 months (β = -0.67, p = 0.016). Post-menopausal women in the AE group showed greater improvement in executive functions compared to the ST group and pre-menopausal women. Models controlled for age, education, and baseline cognitive performance.ConclusionsOur results provide novel evidence that AE improves cognition with pronounced executive functions benefits in post-menopausal women, a population at higher risk for dementia. Since women are at a higher risk of developing Alzheimer's disease compared to men, these findings support AE as a relevant strategy to promote women's brain health. Although this is a secondary analysis, it may inform future exercise trials targeting women.
Objective:This study examined gender differences in the association between recreational walking and indoor and outdoor fall rates among older adults. Methods:The Healthy Aging and Neighborhood Study is a prospective cohort that included 716 community-dwelling adults aged 65-95 years in central and northeastern Massachusetts, USA (2018-2023). Recreational walking at baseline was measured by the frequency of walking for exercise for at least 10 min in the participants' neighborhood. Falls were reported on monthly falls calendars, and the circumstances for reported falls were collected via subsequent telephone interviews. Mixed effects negative binomial models were used to estimate gender differences in the associations of recreational walking with rates of indoor and outdoor falls, separately. Models were adjusted for sociodemographic variables, physical health, functional status, lifestyle behaviors, mental health, and fear of falling. Results:There were 394 (55%) female and 322 (45%) male participants enrolled in the study, and the mean (SD) age was 74.08 (6.29). About 61% of participants engaged in recreational walking at least once weekly. Women had lower outdoor fall rates than men (32 vs. 40 per 100 person-years), while indoor fall rates did not significantly differ by gender (31 vs. 34 per 100 person-years). Women engaging in recreational walking at least once weekly had a 62% lower indoor fall rate [IRR (95% CI): 0.38 (0.21, 0.71)] than those who did not. No significant associations were observed between recreational walking and outdoor falls for both women and men. Discussion:Among community-dwelling older women, but not men, a higher frequency of recreational walking was associated with lower rates of indoor falls, while no changes were seen with outdoor falls. Increasing recreational walking may be a viable focus for fall prevention programs in the community, especially for older women.
