Dual cognitive and physical activities and cognitive decline in older Māori and non-Māori

Abstract

Results: A systematic review, including a meta-analysis, was conducted of randomised controlled trials (RCTs) of cognitively loaded physical activity interventions for community dwelling older adults with MCI. It found limited but promising evidence that such interventions improve global cognition. Cognitively loaded physical activity is comprised of the combination of physical and cognitive demands and could create accumulation and/or synergistic effects resulting in cognitive benefits. Data from an observational longitudinal cohort study of octogenarian Māori and non-Māori were used to investigate associations between cognitively loaded physical activity and cognitive decline annually over six years. In the non-Māori sample, participation in such activity was protective against cognitive decline. No statistically significant association was established in the Māori sample, perhaps due to applying Western measures to Māori without a Māori worldview. The above studies’ findings facilitated the development and implementation of a pilot RCT exploring the feasibility, acceptability, and effectiveness of physical activities with different degrees of cognitive-load on cognitive function in older non-Māori adults with MCI. The results indicated that the arm with the greatest cognitive-load (the Ronnie Gardiner Method [RGM]) was generally feasible and acceptable. The findings in the RGM arm displayed positive trends in global cognitive function and statistically significant improvement in executive and physical function. This evidence supports proceeding with a definitive RCT to establish the effects of the RGM. Conclusion: These observations indicate that physical activity with greater cognitive-load is potentially promising to postpone cognitive decline, especially for populations vulnerable to dementia, like those with MCI and people of advanced age. Further research investigating the mechanisms of accumulation and/or synergistic effect through participating in cognitively loaded physical activities is warranted along with exploration of wider development programmes with dual modality physical and cognitive activities.