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.