The Mental Activity and eXercise (MAX) trial: Effects on physical function and quality of life among older adults with cognitive complaints

Background: Older adults with cognitive complaints are vulnerable to dementia, physical impairments, and poor quality of life. Exercise and mental activity may improve physical function and health-related quality of life (HRQOL) but combinations have not been investigated systematically. The Mental Activity and eXercise (MAX) trial found that mental activity plus exercise over 12 weeks improved cognitive function (primary outcome) in sedentary older adults with cognitive complaints. Objective: To investigate the effects of combinations of two mental activity and exercise programs on physical function and HRQOL (secondary outcomes). Methods: Participants (n = 126, age 73 6 years, 65% women) were randomized to 12 weeks of exercise (aerobic exercise or stretching/toning, 3 x 60 min/week) plus mental activity (computer-based cognitive training or educational DVDs, 3 x 60 min/week) using a factorial design. Assessments included the Senior Fitness Test (physical function), Short Form-12 physical and mental sub-scales (HRQOL), and CHAMPS questionnaire (physical activity). Results: There were no differences between groups at baseline (p > 0.05). We observed improvements over time in most physical function measures [chair stands (p-for-time = 0.001), arm curls (p-for-time < 0.001), step test (p-for-time = 0.003), sit & reach (p-for-time = 0.01), and back scratch (p-for-time = 0.04)] and in physical HRQOL (p-for-time = 0.04). There were no differences in change between groups (group * time p > 0.05). Changes in most physical function measures and physical HRQOL correlated with physical activity changes. Conclusion: Combined mental activity and exercise interventions of various types can improve both physical function and physical HRQOL among sedentary older adults with cognitive complaints. Exercise control group design should be carefully considered as even light exercise may induce benefits in vulnerable older adults.