The Impact of Physical Exercise on Working Memory in Elderly People With Mild Cognitive Impairment

N/AEnrolling By InvitationNCT07644156

Shanghai University of Sport80 enrolled

Overview

Age-related cognitive decline has evolved into a global public health concern, with deteriorated executive function serving as its predominant manifestation. Working memory, a vital component of executive function, refers to a capacity-limited system that temporarily stores and manipulates information during sophisticated cognitive processes such as language comprehension, learning, and reasoning. It constitutes the core of general cognitive functioning and underpins daily functional performance. The prefrontal cortex is a pivotal brain region subserving working memory and is highly vulnerable to pathological aging. Advancing age triggers prefrontal cortical atrophy and reduced synaptic density, which in turn induces working memory impairment. Consistently, existing evidence identifies working memory as one of the cognitive domains most susceptible to aging and among the first functions compromised in neurodegenerative disorders including Alzheimer's disease. As a non-pharmacological strategy, physical exercise intervention has been validated to exert favorable effects on cognitive improvement. Both aerobic and resistance training effectively ameliorate working memory; nevertheless, head-to-head evidence comparing their intervention efficacy among older adults with mild cognitive impairment (MCI) remains scarce, particularly regarding underlying neurophysiological mechanisms. This study aims to explore the impacts of physical training on working memory in older women living with MCI. Accordingly, the present study aimed to investigate the effects of both a single exercise session and a 12-week intervention on upper- and lower-limb muscle strength and working memory in older women with MCI. In addition, we sought to examine the statistical associations between changes in muscle strength and working memory, with particular attention to the potential mediating role of muscle strength changes. Previous studies have suggested that interventions targeting muscle strength and physical function in middle-aged and older adults are commonly implemented over 12-52 weeks at a frequency of two to three sessions per week, whereas exercise interventions targeting cognitive function in older adults are often conducted over 12-24 weeks at a similar frequency. Based on this evidence, together with feasibility considerations in residential care settings, we adopted a 12-week intervention delivered three times per week. This study contributes to the literature by integrating both acute and chronic effects within a single randomized controlled framework and by exploring the muscle strength-cognition pathway as a potential explanatory mechanism for exercise-related cognitive benefits.

Study Type

Interventions

Resistance band exercise interventionBEHAVIORAL

Perform resistance training using Thera-Band resistance bands. Warm up for 5 minutes; proceed to the main workout, which consists of 10 exercises. Perform 2 sets of each exercise, with 8 to 12 repetitions per set, resting for 1 minute between sets. The session lasts approximately 25 to 30 minutes; finish with a cool-down and stretching.

Brisk walking interventionBEHAVIORAL

Warm up for 5 minutes, then walk briskly for 25 to 30 minutes once you reach your target heart rate for moderate intensity (65%-75% of HRmax); finish with a cool-down.

Eight-Section brocade exercise interventionBEHAVIORAL

A 5-minute warm-up and stretching session; followed by two sets of the 'Eight Brocades' fitness qigong routine compiled by the General Administration of Sport, lasting approximately 24 minutes in total; and finally, a cool-down and relaxation session.

ControlBEHAVIORAL

Maintain current routine.

Eligibility

Sex: ALLMin age: 65 YearsMax age: 95 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Age \>= 65years; 2. Free from major organic diseases or cardiovascular diseases, and showing no contraindications to exercise according to the pre-exercise screening questionnaire developed by the American Heart Association (AHA) and the American College of Sports Medicine (ACSM); 3. Able to communicate effectively and, subject to their condition, cooperate in completing questionnaires and tests; 4. Willing to participate in this study and sign an informed consent form. Exclusion Criteria: 1. Suffering from severe cognitive impairment, mental illness or other neurodegenerative diseases (such as Parkinson's dementia, stroke, frontotemporal degeneration, vascular dementia, Lewy body dementia, etc.), where the condition impairs communication or the ability to follow experimental instructions; 2. Suffering from severe physical injuries that prevent prolonged standing, standing or participation in physical activities; 3. Currently taking, or having taken in the recent past, psychotropic drugs or medications that affect physical mobility; 4. Plans for surgical treatment in the near future (within the next 6 months); 5. Unwillingness to participate in or withdrawal from this study.

Outcomes

Primary Outcomes

The N-back working memory task

Implemented using E-Prime 3.0 software, with Arabic numerals as stimuli. Participants were required to respond according to the task instructions, recording reaction time (RT)and accuracy (ACC).

Time frame: This study runs from 4 March 2026 to 31 August 2026. Each participant receives assessments within one week at baseline and one week after intervention.

Secondary Outcomes

Montreal Cognitive Assessment Scale

Global cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), which includes 11 items covering attention, executive function, memory, language, visuospatial ability, abstraction, calculation, and orientation. The total score ranges from 0 to 30, with higher scores indicating better cognitive function. One point was added for participants with fewer than 12 years of education.