Clinician Article

A 12-Week Physical and Cognitive Exercise Program Can Improve Cognitive Function and Neural Efficiency in Community-Dwelling Older Adults: A Randomized Controlled Trial.

  • Nishiguchi S
  • Yamada M
  • Tanigawa T
  • Sekiyama K
  • Kawagoe T
  • Suzuki M, et al.
J Am Geriatr Soc. 2015 Jul;63(7):1355-63. doi: 10.1111/jgs.13481. Epub 2015 Jun 26. (Original)
PMID: 26114906
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  • Geriatrics
    Relevance - 6/7
    Newsworthiness - 5/7
  • Public Health
    Relevance - 5/7
    Newsworthiness - 5/7
  • Family Medicine (FM)/General Practice (GP)
    Relevance - 5/7
    Newsworthiness - 4/7
  • General Internal Medicine-Primary Care(US)
    Relevance - 5/7
    Newsworthiness - 4/7
  • Internal Medicine
    Relevance - 5/7
    Newsworthiness - 4/7
  • Neurology
    Relevance - 4/7
    Newsworthiness - 3/7


OBJECTIVES: To investigate whether a 12-week physical and cognitive exercise program can improve cognitive function and brain activation efficiency in community-dwelling older adults.

DESIGN: Randomized controlled trial.

SETTING: Kyoto, Japan.

PARTICIPANTS: Community-dwelling older adults (N = 48) were randomized into an exercise group (n = 24) and a control group (n = 24).

INTERVENTION: Exercise group participants received a weekly dual task-based multimodal exercise class in combination with pedometer-based daily walking exercise during the 12-week intervention phase. Control group participants did not receive any intervention and were instructed to spend their time as usual during the intervention phase.

MEASUREMENTS: The outcome measures were global cognitive function, memory function, executive function, and brain activation (measured using functional magnetic resonance imaging) associated with visual short-term memory.

RESULTS: Exercise group participants had significantly greater postintervention improvement in memory and executive functions than the control group (P < .05). In addition, after the intervention, less activation was found in several brain regions associated with visual short-term memory, including the prefrontal cortex, in the exercise group (P < .001, uncorrected).

CONCLUSION: A 12-week physical and cognitive exercise program can improve the efficiency of brain activation during cognitive tasks in older adults, which is associated with improvements in memory and executive function.

Clinical Comments


Quite interesting approach to investigate possible effects of physical activity and other tasks to improve cognitive functioning. Nevertheless some (in the limitations mentioned) points would have been important to know (e.g. sustainable effect?, improvement caused by cognitive tasks or by physical activity ...).


This is an interesting study but it does have limitations - e.g., results based on a small number (48 total) of volunteers, short duration (12 weeks) of study with no follow-up evaluation, study design did not permit comparisons of the effects of the components (cognitive, physical exercise) individually and both together, and lack of between group differences at the conclusion (testing was looking for significance of group-by-time changes, not between groups). Larger and longer-term studies that allow us to examine individual and combined effects are needed.


It is well known that cognitive and exercise training may ameliorate the performances of old people. However, we do not know whether performances in tests translate into better quality of life, which was not measured in this paper. Furthermore, we cannot say whether what "spend their time as ususal" for Japanese people automatically applies to our patients in different countries and settings.


The most important question not addressed by this study is how sustained are the effects of such interventions.

Public Health

Well timed article, good preliminary evidence.

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