Aquatic Cognitive-Motor Exercise Training on Cognition and Neurotrophic Factors in Older Adults

Research Objectives: Memory, processing speed, and executive function decline with advancing age. Reduced neurotrophic factors, such as brain-derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1) may underlie age-associated cognitive decline. This pilot study aimed to assess the impact of aquatic cognitive-motor exercise training on cognition and neurotrophic factors among older adults. We hypothesized that aquatic exercise would improve cognition and elevate the concentration of BDNF and IGF-1.

Design: Randomized controlled trial

Setting: Senior living community

Participants: Twenty-five apparently healthy older adults were randomized to an aquatic exercise training (n=13, 83±7 years) or control group (n=12, 81±8 years).

Interventions: The aquatic exercise group received 45 minutes of cognitive-motor exercise in the swimming pool, at a moderate intensity, 3 times per week, for 8 weeks. The control group attended a 1-hour fall prevention education class.

Main Outcome Measures: The primary outcome measures included 3 cognitive tests: Stroop (assessing processing speed and selective attention), Trail-Making (assessing visual attention and task switching), and Digit Span Backward (assessing working memory and executive function). The secondary outcome measures included serum concentrations of BDNF and IGF-1.

Results: Age, sex, body mass index, blood pressure, physical activity, and gait speed were not different at baseline between the groups. There was a 95% adherence rate for the aquatic exercise program. After the intervention, the aquatic exercise group improved various measures of cognition as assessed by the Stroop color and word score (∆3.2 with 95% CI 0.4 to 6.0), Trail Making Test-part B (∆-20.3 seconds with 95% CI -43 to -5.0), and Digit Span Backward score (∆0.8 with 95% CI 0.1 to 1.5). In contrast, no such changes were observed in the control group. Serum concentrations of BDNF and IGF-1 did not change for either group.

Conclusions: When coupled with a high adherence rate to the prescribed exercises, cognitive-motor exercise training in aquatic environments may offer an effective strategy for enhancing cognitive function in older adults residing in senior living communities.

Author(s) Disclosures: The authors have no conflict of interest to declare.