"Physical Activity and Cognitive Health: The Power of Combined Aerobic and Strength Training

A new study, published in GeroScience, investigated the link between physical exercise and cognitive health in the oldest old (aged 85–99 years). 184 cognitively healthy participants were assessed using the CHAMPS questionnaire and a cognitive battery, dividing them into three groups: sedentary, cardio only, and cardio plus strength training. The cardio plus strength training group exhibited the highest cognitive performance, especially in processing speed and executive functioning tasks like the coding task and symbol search. They also outperformed the cardio-only group in Symbol Search, Letter Fluency, and the Stroop Color-Word task. These findings suggest that combining aerobic and resistance training exercises is associated with improved cognitive function in the oldest old, highlighting the potential for exercise to enhance mental agility and thinking speed. This challenges the stereotype of physical inactivity in old age, as nearly 70% of participants were already active.

Key Points

1. Study Focus: The research explored the relationship between physical exercise and cognitive performance in cognitively healthy individuals aged 85 to 99 years old.

2. Participants and Methods: The study included 184 participants who completed the CHAMPS questionnaire to report their exercise habits and underwent a cognitive battery including tasks like the NIH-TB, Coding, Symbol Search, Letter Fluency, and the Stroop task.

3. Exercise Groups: Participants were divided into three groups: sedentary, cardio only, and cardio plus strength training.

4. Cognitive Performance: The cardio plus strength training group showed the highest overall cognitive performance, particularly in tasks measuring processing speed and executive functioning.

5. Significant Results: This group scored significantly better on the Coding task and Symbol Search compared to the sedentary group, and also outperformed the cardio-only group on Symbol Search, Letter Fluency, and the Stroop Color-Word task.

6. Implications: The findings suggest that a combination of aerobic and resistance training exercises is linked to better cognitive health in the elderly, challenging stereotypes about physical inactivity in old age.

7. Future Research: Further studies are needed to determine causation, identify the most effective types of exercises, and explore the potential of exercise as a treatment for neurocognitive disorders.

The Cognitive Benefits of Exercise in the Oldest: A Path to Healthy Aging

As the global population ages, maintaining cognitive health has become a significant concern. With the number of people diagnosed with Alzheimer's disease in the U.S. projected to reach nearly 14 million by 2060, up from just over 6 million in 2020, identifying practical approaches to support cognitive function in older adults is critical. One promising area of research explores the relationship between physical exercise and cognitive health in the elderly, those aged 85 years and older. The study, published in the journal GeroScience, delves into this topic, revealing that regular engagement in both aerobic and strength training exercises is associated with better cognitive performance in the elderly.

Understanding the Study: Methods and Participants

To explore the effects of physical exercise on cognition in the old, 184 cognitively healthy individuals aged 85 to 99 years, were assessed This sample included 98 females, with a mean score of 24.81 on the Montreal Cognitive Assessment (MoCA), a widely used cognitive screening tool. Participants reported their exercise habits using the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire and completed a comprehensive cognitive battery. This battery included tasks from the NIH Toolbox Cognition Battery (NIH-TB), Coding, Symbol Search, Letter Fluency, and the Stroop task.

Based on their CHAMPS responses, participants were divided into three groups:

1. Sedentary (n = 58; MoCA mean score = 24; 36 females; mean age = 89.03)

2. Cardio (n = 60; MoCA mean score = 25.08; 29 females; mean age = 88.62)

3. Cardio + Strength Training (n = 66; MoCA mean score = 25.28; 33 females; mean age = 87.91)

Key Findings: Exercise and Cognitive Performance

The analysis controlled for years of education, NIH-TB Crystallized Composite scores, and the metabolic equivalent of tasks (METs). The findings revealed that the cardio + strength training group outperformed the other groups in overall cognitive performance. Specifically, they scored significantly higher on the Coding task (p<0.001) and Symbol Search (p<0.05) compared to the sedentary group. Furthermore, this group also performed better on Symbol Search, Letter Fluency, and the Stroop Color-Word task compared to the cardio-only group (p<0.05).

These results suggest that a combination of aerobic and resistance training exercises is linked to improved cognitive measures of processing speed and executive functioning in the oldest-old. The study highlights a potential synergistic effect when both types of exercise are incorporated into the routine.

Implications for Healthy Aging

The implications of these findings are profound. Regular engagement in both aerobic and strength training exercises could be a key strategy for maintaining or even enhancing cognitive health in the last decades of life. This is not just about statistical differences; it translates into real-world cognitive abilities that significantly impact the quality of life for older adults.

The study also challenges the stereotype that old age is synonymous with physical inactivity. Nearly 70% of the participants were already engaging in some form of physical exercise before the study. This indicates that a significant proportion of the oldest-old population is active and can benefit from optimized exercise routines.

Practical Recommendations for Healthcare Providers

Healthcare providers can use these findings to encourage older adults to incorporate a mix of aerobic and strength exercises into their wellness plans. Studies have shown that slowing cognitive decline can reduce medical expenses and improve quality of life. Therefore, recommending a varied exercise regimen could be a practical and effective approach to support cognitive health in older patients.

Future Research Directions

While the study establishes a correlation between mixed exercise routines and higher cognitive test scores, it does not establish causation. Future research should aim to determine whether these exercises directly cause improvements in cognitive function. Additionally, several questions remain unanswered:

• What specific types of aerobic and strength exercises are most effective for cognitive health?

• Is walking as beneficial as jogging?

• Does weightlifting have the same impact as resistance band exercises?

• How much exercise is needed to see noticeable cognitive benefits?

Moreover, exploring the potential of exercise as a treatment for neurocognitive disorders in older adults is a critical next step. These results suggest that physical activity can serve as a preventive measure, but could it also be used as an active treatment for cognitive decline? This possibility opens up new avenues for research and practical applications in geriatric care.

Conclusion: A Path to Enhanced Cognitive Health

In conclusion, this study provides robust evidence that engaging in both aerobic and strength training exercises is associated with better cognitive performance in the oldest-old. As the global population continues to age, these findings offer hope for healthier aging and present a practical approach to maintaining cognitive health in the later stages of life. Encouraging older adults to adopt a varied exercise routine could be a simple yet powerful strategy to enhance cognitive function and overall well-being in their golden years.

The aging body, much like a machine, requires regular upkeep and maintenance to function optimally. By understanding and harnessing the benefits of physical exercise, we can support cognitive health and improve the quality of life for the elderly, helping them live fully and independently well into their later years.

1. How does physical exercise benefit cognitive health in the elderly? Regular physical exercise, particularly a combination of aerobic and strength training, has been shown to improve cognitive functions such as processing speed, executive functioning, and mental agility in individuals aged 85 and older. This includes better performance on cognitive tests like symbol coding and letter fluency compared to sedentary individuals​

2. What types of exercises are most effective for cognitive health in the elderly? Combining aerobic exercises (such as swimming, cycling, and walking) with strength training (like weightlifting and resistance exercises) has been found to be the most effective for enhancing cognitive health. This combination appears to have a synergistic effect, offering more significant cognitive benefits than either type of exercise alone​ ​.

3. Can exercise prevent cognitive decline in older adults? While the study suggests a strong correlation between regular physical exercise and better cognitive performance, it does not establish a direct causal relationship. However, the evidence supports the idea that engaging in physical activity can help maintain or even improve cognitive health, potentially acting as a preventive measure against cognitive decline​ ​.

4. How much exercise is needed to see cognitive benefits in the elderly? The specific amount of exercise needed can vary, but studies suggest that regular engagement in both aerobic and strength training activities, regardless of the intensity and duration, is associated with better cognitive outcomes. Further research is needed to determine the optimal types and amounts of exercise for maximizing cognitive health​

5. Is there a difference in cognitive benefits between low-intensity and high-intensity exercises? Research indicates that both low-intensity and high-intensity exercises can offer cognitive benefits. However, combining different types of exercises, such as low-intensity aerobic activities and strength training, may provide the most substantial improvements in cognitive function. More studies are required to compare the specific impacts of exercise intensity on cognitive health in the elderly. ​

Journal Reference

Ho, B.D., Gullett, J.M., Anton, S. et al. Associations between physical exercise type, fluid intelligence, executive function, and processing speed in the oldest-old (85 +). GeroScience 46, 491–503 (2024). https://doi.org/10.1007/s11357-023-00885-4

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