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Background: Physical and cognitive interventions have been shown to induce positive effects on older adults’ executive functioning. However, since participants with different background characteristics may respond differently to such interventions, we investigated whether training effects on executive functions were associated with sex, training compliance, and age. We also investigated if change in global cognition was associated with physical and cognitive training intervention-induced changes in executive functions. Methods: Exploratory data from a randomized controlled trial were analyzed. Participants were 70–85-year-old men and women who received a 12-month physical (PT) or physical and cognitive training (PTCT) intervention. Measurements of executive functions related to inhibition (Stroop), set shifting (Trail Making Test B) and updating (Verbal Fluency) were performed at baseline and 12 months. Data were analyzed using a longitudinal linear path model for the two measurements occasion. Results: Stroop improved significantly more in women and participants in the low compliance subgroup who received PTCT than in counterparts in the PT subgroup (difference –8.758, p = 0.001 and difference –8.405, p = 0.010, respectively). In addition, TMT B improved after the intervention in the low compliance PTCT subgroup and worsened in the corresponding PT subgroup (difference –15.034, p = 0.032). No other significant associations were observed. Conclusion: Executive functions in women and in the participants, who only occasionally engaged in training showed greater improvement after the PTCT than PT intervention. However, the additional extra benefit gained from the PTCT intervention was uniquely expressed in each executive function measured in this study. publishedVersion

Objective: This study investigated whether (1) cognitive functions change after the transition from the perimenopausal to the postmenopausal stage, (2) cognitive functions and walking are associated in middle-aged women, and (3) cognitive functions assessed in perimenopause are associated with walking after reaching the postmenopause or vice versa. Methods: In total, 342 women, categorized as early (n = 158) or late perimenopausal (n = 184), were included in the study and followed up until postmenopausal. Psychomotor speed, executive functions related to set-shifting and updating, working memory, and visual memory were assessed. Walking was assessed with walking speed, walking distance, and dual-task cost in walking speed. Data was analyzed using the paired-samples t test, Wilcoxon signed rank test, multiple linear regression analysis, and structural equation modeling. Results: We found small but significant improvements in psychomotor speed (P = 0.01) and working memory (P < 0.001) among early perimenopausal and in psychomotor speed (P = 0.001), set-shifting (P = 0.02), visual memory (P = 0.002), and working memory (P < 0.001) among late perimenopausal women after the transition from peri- to postmenopause. Walking speed (β = 0.264, P = 0.001) and dual-task cost (β = 0.160, P = 0.03) were associated with updating, and walking distance was associated with updating and set-shifting (β = 0.198, P = 0.02, β=−0.178 P = 0.04 respectively) among the late perimenopausal women. We found no longitudinal associations between cognitive functions and walking. Conclusion: Cognitive performance remained unchanged or improved after reaching postmenopause. Cognitive functions and walking were associated during the late perimenopause, but the association depended on the cognitive process and nature of the physical task. Cognitive performance was not associated with walking after reaching postmenopause or vice versa. peerReviewed

BackgroundExecutive functions underlie self-regulation and are thus important for physical activity and adaptation to new situations. The aim was to investigate, if yearlong physical and cognitive training (PTCT) had greater effects on physical activity among older adults than physical training (PT) alone, and if executive functions predicted physical activity at baseline, after six (6m) and twelve months (12m) of the interventions, one-year post-intervention follow-up and an extended follow-up during COVID-19 lockdown.MethodsData from a single-blinded, parallel-group randomized controlled trial (PASSWORD-study, ISRCTN52388040) were utilized. Participants were 70-85 years old community-dwelling men and women from Jyväskylä, Finland. PT (n = 159) included supervised resistance, walking and balance training, home-exercises and self-administered moderate activity. PTCT (n = 155) included PT and cognitive training targeting executive functions on a computer program. Physical activity was assessed with a one-item, seven-scale question. Executive functions were assessed with color-word Stroop, Trail Making Test (TMT) B-A and Letter Fluency. Changes in physical activity were modeled with multinomial logistic models and the impact of executive functions on physical activity with latent change score models.ResultsNo significant group-by-time interaction was observed for physical activity (p>0.1). The subjects were likely to select an activity category higher than baseline throughout the study (pooled data: B = 0.720-1.614, pConclusionsCognitive training did not have additive effects over physical training alone on physical activity, but multicomponent training and higher executive function at baseline may support adaptation to and maintenance of a physically active lifestyle among older adults.

Gait speed is a measure of health and functioning. Physical and cognitive determinants of gait are amenable to interventions, but best practices remain unclear. We investigated the effects of a 12‐month physical and cognitive training (PTCT) on gait speed, dual‐task cost in gait speed, and executive functions (EFs) compared to physical training (PT) (ISRCTN52388040). Community‐dwelling older adults, who did not meet physical activity recommendations, were recruited (n=314). PT included supervised walking/balance (once weekly) and resistance/balance training (once weekly), home exercises (2‐3 times weekly) and moderate aerobic activity 150 minutes/week in bouts of >10 minutes. PTCT included the PT and computer training (CT) on EFs 15‐20 minutes, 3‐4 times weekly. The primary outcome was gait speed. Secondary outcomes were 6‐minute walking distance, dual‐task cost in gait speed, and EF (Stroop and Trail Making B‐A). The trial was completed by 93% of the participants (age 74.5 [SD3.8] years; 60% women). Mean adherence to supervised sessions was 59‐72% in PT and 62‐77% in PTCT. Home exercises and CT were performed on average 1.9 times/week. Weekly minutes spent in aerobic activities were 188 (median 169) in PT and 207 (median 180) in PTCT. No significant interactions were observed for gait speed (PTCT‐PT, 0.02; 95%CI ‐0.03, 0.08), walking distance (‐3.8; ‐16.9, 9.3) or dual‐task cost (‐0.22; ‐1.74, 1.30). Stroop improvement was greater after PTCT than PT (‐6.9; ‐13.0, ‐0.8). Complementing physical training with EFs training is not essential for promotion of gait speed. For EF’s, complementing physical training with targeted cognitive training provides additional benefit. peerReviewed

Iäkkäiden henkilöiden osuus väestössä kasvaa, jonka vuoksi myös lonkkamurtumien määrä nousee. Lonkkamurtuma on iäkkäälle henkilölle dramaattinen tapahtuma, joka heikentää elämänlaatua ja lisää laitoshoidon ja kuoleman riskiä. Yksilölle koituvan haitan lisäksi lonkkamurtumien hoidosta ja kuntoutuksesta aiheutuu kustannuksia yhteiskunnalle. Heikon kognitiivisen toimintakyvyn on todettu olevan yhteydessä iäkkäiden henkilöiden heikentyneeseen tasapainon hallintaan, joka osaltaan lisäävät kaatumisen riskiä. Tämän tutkielman tarkoitus oli selvittää onko kognitiivisen toimintakyvyn taso yhteydessä lonkkamurtumasta toipuvien iäkkäiden henkilöiden tasapainon hallintaan ja tasapainon varmuuteen. Tutkielmassa käytettiin aineistona Promo (The Promoting Mobility after Hip fracture) – tutkimuksen alkumittausaineistoa. Aineisto kerättiin Keski-Suomen keskussairaalassa vuosina 2008-2010 reisiluun kaulan tai ison sarvennoisen alueella sijaitsevan lonkkamurtuman vuoksi leikatuista yli 60-vuotiaista Jyväskylässä tai lähikunnissa asuvista miehistä ja naisista, jotka kykenivät asumaan ja liikkumaan itsenäisesti. Poissulkukriteereinä olivat: vakava sydänverisuoni tai keuhkosairaus, halvaus, etenevä sairaus (esim. ALS), alkoholismi, masennus (BDI-11 >29) tai alhainen kognitiivinen toimintakyky (Mini-Mental State Examination, MMSE 29). Balance and mobility of the participants were measured with the Berg’s balance scale and the Time up and go-test. Balance confidence of participant was measured with the ABC-test and cognitive function of the participants was measured with the Minimental state examination- test (MMSE). For the data analyses participants were divided into two separate groups based on their cognitive function. Participants were grouped based on mild cognitive impairment (MMSE 18-24) and normal cognitive function (MMSE≥25). Mean difference between the groups were analysed with independent samples t-test, Mann Whitneyn U-test and χ²-test. Association between cognitive functions, balance and balance confidence were analysed with linear regression analyses. Participants in groups differed from each other statistically significantly by age (p=0.005) and education (p=0.042). Persons with normal cognitive function perform better in tasks requiring balance and mobility than those with mild cognitive impairment. They also had higher balance confidence. Linear regression analyses showed that there were statistically significant associations between cognitive functions, balance and balance confidence. The model adjusted for age and education showed that there was still statistically significant association between cognitive function and balance confidence (p=0.027). Conclusion: cognitive function is associated with balance and balance confidence in a elderly people recovering from hip fracture.