Aquatic Cognitive–Motor Exercise for Cognition, Balance, and Functional Mobility in Older Adults

ABSTRACT Introduction Cognitive declines and mobility challenges in older adults often hinder exercise, leading to a sedentary lifestyle. Addressing both cognitive and physical health is crucial for enhancing overall well-being in older adults. The purpose of this study was to assess the feasibility and effectiveness of aquatic cognitive–motor exercise on cognition, balance, and functional mobility in older adults. Methods This pilot randomized controlled study included 25 participants from two retirement communities who were randomly assigned to a control (n = 12, 81 ± 8 yr old) or aquatic exercise group (n = 13, 83 ± 7 yr old). The aquatic exercise group received 45 min of moderate-intensity cognitive–motor exercise three times per week for 8 wk. The control group received one fall prevention education class. Results The session attendance rate for the aquatic exercise program was 95%. Between-group comparisons showed that 8 wk of aquatic exercise improved various measures of cognition with a medium effect size, as assessed by the Stroop Color and Word Test (∆ 2.8, d = 0.51) and the Trail Making Test part B (∆ −19.2 s, d = −0.59). Gait speeds while walking forward (∆ 0.04 m·s−1, d = 0.43) and counting backward by serial 7s (∆ 0.05 m·s−1, d = 0.43) were improved with a small effect size in the aquatic exercise intervention. This change was recognized as a clinically meaningful improvement in older adults. The aquatic intervention group had a medium to large effect size improvement in speed with the Four Square Step Test (∆ −0.6 s, d = −0.42), Timed Up and Go test (∆ −1.1 s, d = −0.50), and Timed Up and Go cognitive test (∆ −1.0 s, d = −0.56), whereas only negligible to small changes were noted with single-leg balance measures. Conclusions The aquatic cognitive–motor exercise program is feasible and enhanced cognition and functional mobility in older adults.