The Study of Mental and Resistance Training (SMART) study—resistance training and/or cognitive training in mild cognitive impairment: a randomized, double-blind, double-sham controlled trial

Maria A Fiatarone Singh; Nicola Gates; Nidhi Saigal; Guy C Wilson; Jacinda Meiklejohn; Henry Brodaty; Wei Wen; Nalin Singh; Bernhard T Baune; Chao Suo; Michael K Baker; Nasim Foroughi; Yi Wang; Perminder S Sachdev; Michael Valenzuela

doi:10.1016/j.jamda.2014.09.010

The Study of Mental and Resistance Training (SMART) study—resistance training and/or cognitive training in mild cognitive impairment: a randomized, double-blind, double-sham controlled trial

J Am Med Dir Assoc. 2014 Dec;15(12):873-80. doi: 10.1016/j.jamda.2014.09.010. Epub 2014 Oct 23.

Authors

Affiliations

¹ Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, Sydney Medical School, The University of Sydney, Lidcombe, New South Wales, Australia; Hebrew SeniorLife, Boston, MA; Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA. Electronic address: maria.fiataronesingh@sydney.edu.au.
² Private Neuropsychology Practice, Mosman, New South Wales, Australia.
³ Exercise Health and Performance, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia.
⁴ School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.
⁵ School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Center for Healthy Brain Ageing (CHeBA), NPI, Euroa Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia.
⁶ Royal Prince Alfred and Balmain Hospital Balmain Hospital, Balmain, New South Wales, Australia; Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
⁷ Department of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
⁸ Monash Clinical and Imaging Neuroscience, School of Psychology and Psychiatry, Monash University, Clayton, Victoria, Australia.
⁹ Exercise Health and Performance, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia; Australian Catholic University, New South Wales, Australia.
¹⁰ Clinical and Rehabilitation Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia.
¹¹ Department of Medicine and the Diabetes Center, University of California at San Francisco, San Francisco, CA.
¹² Regenerative Neuroscience Group, Brain and Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia.

PMID: 25444575
DOI: 10.1016/j.jamda.2014.09.010

Abstract

Background: Mild cognitive impairment (MCI) increases dementia risk with no pharmacologic treatment available.

Methods: The Study of Mental and Resistance Training was a randomized, double-blind, double-sham controlled trial of adults with MCI. Participants were randomized to 2 supervised interventions: active or sham physical training (high intensity progressive resistance training vs seated calisthenics) plus active or sham cognitive training (computerized, multidomain cognitive training vs watching videos/quizzes), 2-3 days/week for 6 months with 18-month follow-up. Primary outcomes were global cognitive function (Alzheimer's Disease Assessment Scale-cognitive subscale; ADAS-Cog) and functional independence (Bayer Activities of Daily Living). Secondary outcomes included executive function, memory, and speed/attention tests, and cognitive domain scores.

Results: One hundred adults with MCI [70.1 (6.7) years; 68% women] were enrolled and analyzed. Resistance training significantly improved the primary outcome ADAS-Cog; [relative effect size (95% confidence interval) -0.33 (-0.73, 0.06); P < .05] at 6 months and executive function (Wechsler Adult Intelligence Scale Matrices; P = .016) across 18 months. Normal ADAS-Cog scores occurred in 48% (24/49) after resistance training vs 27% (14/51) without resistance training [P < .03; odds ratio (95% confidence interval) 3.50 (1.18, 10.48)]. Cognitive training only attenuated decline in Memory Domain at 6 months (P < .02). Resistance training 18-month benefit was 74% higher (P = .02) for Executive Domain compared with combined training [z-score change = 0.42 (0.22, 0.63) resistance training vs 0.11 (-0.60, 0.28) combined] and 48% higher (P < .04) for Global Domain [z-score change = .0.45 (0.29, 0.61) resistance training vs 0.23 (0.10, 0.36) combined].

Conclusions: Resistance training significantly improved global cognitive function, with maintenance of executive and global benefits over 18 months.

Keywords: Mild cognitive impairment; cognitive training; resistance training.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Aged
Cognitive Dysfunction / therapy*
Double-Blind Method
Female
Humans
Male
Middle Aged
Neuropsychological Tests
Resistance Training / methods*
Treatment Outcome