Effects of Multimodal Training of Combined Cognitive and Physical and Cognitive or Physical Training Only on Cognition and Physical Fitness of Older Adults: A Cluster Randomized Controlled Trial

The purpose of this study is to determine the effectiveness of three training programs (cognitive trainning (A), physical training (B), and combined cognitive and physical training (CCPT, i.e. C)) on the cognition and fitness of community-dwelling older adults in Hong Kong. The study hypotheses will be set as combined training mode will have higher cognition and fitness scores than either cognitive or physical training only and all training modes will have greater positive outcomes than control subjects. The study design is a cluster randomized controlled trial. A total of 285 older adults (age ≥ 60) from twenty elderly centres as clusters will be randomly selected and assigned to intervention groups (IGs, n=16) or control groups (CGs, n=4). Each IG will be randomly assigned to one of the four combinations of three training modes that include Mixed ABC, A+B, C+A, B+C. The intervention will last for 4 months in which the training is conducted for 16 sessions, 2 sessions per week, and 60 minutes per session. Four repeated assessments (pre-test, two post-training tests after 2 months and 4 months, and a follow-up test) will be conducted. The CG will only receive the four repeated assessments but no intervention. The outcome measures include cognitive tests (tests of execution, memory, and psych-social status), physical fitness, and dynamic balance tests. This study will provide substantial evidence that the integrated format of cognitive and physical exercise training will have higher cognition and fitness impact than the single training modes, and all these mixed modalities will have greater positive outcomes than the control condition. If the effectiveness is proven, the intervention can be further explored and extended to the nation so that many more elderly would benefit.