In a ground-breaking discovery that could reshape the approach to elderly cognitive care, Western University and Lawson Health Research Institute researchers have found that a combination of computerized cognitive training and aerobic-resistance exercises (such as walking and cycling along with weight training) can significantly improve cognitive functions, such as memory, attention, recognition and orientation, in older adults with Mild Cognitive Impairment (MCI).
The researchers found the effect of the combined intervention was larger than the individual effects of exercise or cognitive training alone, suggesting a synergism in the sequential combination. They also found Vitamin D supplements, on the other hand, did not appear to contribute to improvement.
According to the latest data published by the Alzheimer’s Association, the global prevalence of dementia is on the rise, impacting over 50 million individuals and costing more than $800 billion. These alarming statistics underscore the imperative to identify new and effective strategies to address neurodegenerative diseases.
The study, led by Western Professor and Lawson Scientist Dr. Manuel Montero-Odasso, offers a new pathway to address declining mental sharpness in the aging population by incorporating aerobic-resistance exercises along with computer-based cognitive training.
“This trial opens new doors in the realm of nonpharmacological interventions for MCI,” said Dr. Montero-Odasso, professor in the departments of medicine, and epidemiology and biostatistics at Schulich School of Medicine & Dentistry and director of Lawson’s Gait & Brain Lab.
“We found through a multidomain approach that pairs aerobic and resistance exercises with computerized cognitive training, there may be hope in delaying the progression from MCI to dementia.” Dr. Montero-Odasso is also a Geriatrician at St. Joseph’s Health Care London and co-lead of the Canadian Therapeutic Platform Trial for Multidomain Interventions to Prevent Dementia (CAN-THUMBS UP) at the Canadian Consortium on Neurodegeneration in Aging (CCNA).
The multi-city clinical trial, published in JAMA Network Open, included 175 participants aged between 60 and 85 with MCI – an intermediate state between normal cognitive aging and early dementia – which is also considered a critical period for early treatments and preventive strategies to address cognitive decline. The 20-week study was structured into five arms, focusing on the combination of different interventions.
The findings show that aerobic-resistance exercises did contribute to improvements in cognition, but it was the addition of cognitive training that truly made a difference. Notably, the addition of vitamin D supplementation did not show any significant benefit. Though previously argued to enhance cognition due to its neuroprotective attributes, the vitamin did not contribute to the overall success of the interventions.
The study, known as the SYNERGIC Trial (Synchronizing Exercises, Remedies in Gait and Cognition), was conducted across five Canadian academic institutions with core of the interventions at the London site – exercise and cognitive training – completed at Western’s Laboratory for Brain and Heart Health.
“The SYNERGIC Trial goes beyond mere numbers and statistics; it’s about understanding the many sides of cognitive health,” said Dr. Kevin Shoemaker, co-author of the study. Dr. Shoemaker is a professor in the School of Kinesiology at Western and Canada Research Chair in the Integrative Physiology of Exercise and Health.
“By bringing together various interventions, we are creating a comprehensive view of well-being that reaches beyond pills and conventional treatments. These findings could lead to real, significant improvements in the lives of people with mild cognitive impairment, changes that could genuinely enhance their quality of life,” said Dr. Shoemaker.
“This is an important advance from a national CCNA team led by Dr. Montero-Odasso. The study shows clearly that intense exercise and cognitive training is an effective and feasible lifestyle intervention that clearly slows the decline in brain function in people with Mild Cognitive Impairment. We are proud that Canadian scientists have shown this to the world,” said Dr. Howard Chertkow, Scientific Director, CCNA, and Chair in Cognitive Neurology and Innovation and Senior Scientist, Baycrest Health Sciences and Rotman Research Institute.
The next phase of the trials
The researchers are now conducting the next phase of the trial. The SYNERGIC-2 trial will provide virtual, at-home interventions to 550 study participants with MCI, including personalized one-on-one coaching, to help make lifestyle and behavioural changes. This trial is being conducted by the Mobility, Exercise and Cognition (MEC) Team which is part of the CCNA.
The SYNERGIC Trial is part of the Canadian Therapeutic Platform Trial for Multidomain Interventions to Prevent Dementia (CAN-THUMBS UP) CCNA’s platform dedicated to dementia prevention and risk reduction research. This work was supported by CCNA, which receives funding from the Canadian Institutes of Health Research (CIHR) and other partner organizations.
The team of researchers involved in the study led by Dr. Montero-Odasso also included Western professors Guangyong Zou and Mark Speechley, Lawson researcher and adjunct professor Frederico Pieruccini-Faria and London Health Sciences Centre statistician Surim Son.
The trial was conducted at five Canadian academic institutions: Western (sponsor site), University of Waterloo, Wilfrid Laurier University, University of Montreal and University of British Columbia.
