Effects of a dual-task intervention program in institutionalized older adults: a pilot randomized controlled trial
DOI:
https://doi.org/10.47197/retos.v68.112463Keywords:
dual-task exercise, institutionalized, physical function, randomized controlled trialAbstract
Objective: to compare the effects of single-task (ST) and dual-task (DT) training on physical and cognitive function in institutionalized older adults.
Methods: Participants included in this pilot study were assigned randomly into two groups, ST (multicomponent physical exercise, MPE) and DT training (MPE + cognitive tasks). Both groups performed the exercise three times per week for 1 month. Short Physical Performance Battery (SPPB), isometric handgrip strength (IHS), Barthel Index and Montreal Cognitive Assessment (MoCA) were used to assess physical and cognitive performance, respectively. Participants were evaluated at the beginning (V1), at the end of the exercise (V2), as well as one month later (V3). Paired Student’s t-test and lineal regression models were used to explore the effect of the exercise interventions.
Results: 24 (58.3% men, mean age 67.33±3.36) institutionalized older adults were included. Adherence in both groups was 100%. After the training period, both groups significantly improved SPPB and IHS, while MoCA only increased in the DT group. At V3, both groups presented significantly higher MoCA scores, although only DT increased IHS scores. Significant differences between groups were observed in ∆V1-V2 SPPB (p-value <0.001) and ∆V1-V3 IHS (p-value <0.05). Once cognitive function was considered, only ∆V1-V2 SPPB [β (95%CI): 1.63 (0.78, 2.47), p-value 0.001] and ∆V1-V2 IHS [β (95%CI): 0.97 (0.10, 1.84), p-value 0.031] were significantly different between groups.
Conclusions: Dual-task exercise may produce greater effect on physical, but not cognitive function, in comparison with single-task exercise in institutionalized older adults. Larger randomized-controlled trials are needed to confirm our findings.
References
Ali, N., Tian, H., Thabane, L., Ma, J., Wu, H., Zhong, Q., Gao, Y., Sun, C., Zhu, Y. & Wang, T. (2022). The Effects of Dual-Task Training on Cognitive and Physical Functions in Older Adults with Cognitive Impairment; A Systematic Review and Meta-Analysis. Journal of Prevention of Alzheimer’s Disease, 9(2), 359–370. https://doi.org/10.14283/JPAD.2022.16/FIGURES/10
Bischoff, L. L., Cordes, T., Meixner, C., Schoene, D., Voelcker-Rehage, C. & Wollesen, B. (2021). Can cognitive-motor training improve physical functioning and psychosocial wellbeing in nursing home residents? A randomized controlled feasibility study as part of the PROCARE project. Aging Clinical and Experimental Research, 33(4), 943–956. https://doi.org/10.1007/S40520-020-01615-Y
Borg, G. A. (1982). Psychophysical bases of perceived exertion. Medicine and Science in Sports and Exercise, 14(5), 377–381. http://www.ncbi.nlm.nih.gov/pubmed/7154893
Brustio, P. R., Rabaglietti, E., Formica, S. & Liubicich, M. E. (2018). Dual-task training in older adults: The effect of additional motor tasks on mobility performance. Archives of Gerontology and Geriatrics, 75, 119–124. https://doi.org/10.1016/J.ARCHGER.2017.12.003
Casas-Herrero, Á., Sáez de Asteasu, M. L., Antón-Rodrigo, I., Sánchez-Sánchez, J. L., Montero-Odasso, M., Marín-Epelde, I., Ramón-Espinoza, F., Zambom-Ferraresi, F., Petidier-Torregrosa, R., Elexpuru-Estomba, J., Álvarez-Bustos, A., Galbete, A., Martínez-Velilla, N. & Izquierdo, M. (2022). Effects of Vivifrail multicomponent intervention on functional capacity: a multicentre, randomized controlled trial. Journal of Cachexia, Sarcopenia and Muscle, 13(2), 884–893. https://doi.org/10.1002/jcsm.12925
Charles, A., Detilleux, J., Buckinx, F., Reginster, J. Y., Gruslin, B. & Bruyère, O. (2020). Physical performance trajectories and mortality among nursing home residents: results of the SENIOR cohort. Age and Ageing, 49(5), 800–806. https://doi.org/10.1093/AGEING/AFAA034
Coelho, H. J. & Marzetti, E. (2023). Is there enough evidence to prescribe exercise to older adults living in residential care? The Lancet Healthy Longevity, 4(6), e237–e238. https://doi.org/10.1016/S2666-7568(23)00063-6
Courel-Ibáñez, J., Buendía-Romero, Á., Pallarés, J. G., García-Conesa, S., Martínez-Cava, A. & Izquierdo, M. (2022). Impact of Tailored Multicomponent Exercise for Preventing Weakness and Falls on Nursing Home Residents’ Functional Capacity. Journal of the American Medical Directors Association, 23(1), 98-104.e3. https://doi.org/10.1016/J.JAMDA.2021.05.037
Crocker, T., Forster, A., Young, J., Brown, L., Ozer, S., Smith, J., Green, J., Hardy, J., Burns, E., Glidewell, E. & Greenwood, D. C. (2013). Physical rehabilitation for older people in long-term care. The Cochrane Database of Systematic Reviews, 2013(2). https://doi.org/10.1002/14651858.CD004294.PUB3
de Fátima Ribeiro Silva, C., Ohara, D. G., Matos, A. P., Pinto, A. C. P. N. & Pegorari, M. S. (2021). Short Physical Performance Battery as a Measure of Physical Performance and Mortality Predictor in Older Adults: A Comprehensive Literature Review. International Journal of Environmental Research and Public Health, 18(20), 10612. https://doi.org/10.3390/IJERPH182010612
Delbroek, T., Vermeylen, W. & Spildooren, J. (2017). The effect of cognitive-motor dual task training with the biorescue force platform on cognition, balance and dual task performance in institutionalized older adults: a randomized controlled trial. Journal of Physical Therapy Science, 29(7), 1137. https://doi.org/10.1589/JPTS.29.1137
Dinamarca M., Rojo F.E., Brito D.C. (2003). Síndrome de Inmovilidad: Diagnóstico situacional y proyecto de atención domiciliaria. Libro de Resúmenes, IV Congreso Latinoamericano de Geriatría y Gerontología COMLAT-IAG. Santiago de Chile, Chile.
Gaete, M., Jorquera, S., Bello-Lepe, S., Mendoza, Y. M., Véliz, M., Alonso-Sanchez, M. F. & Lira, J. (2023). Resultados estandarizados del Montreal Cognitive Assessment (MoCA) para cribado neurocognitivo en población chilena. Neurología, 38(4), 246–255. https://doi.org/10.1016/j.nrl.2020.08.017
Guralnik, J. M., Simonsick, E. M., Ferrucci, L., Glynn, R. J., Berkman, L. F., Blazer, D. G., Scherr, P. A. & Wallace, R. B. (1994). A Short Physical Performance Battery Assessing Lower Extremity Function: Association With Self-Reported Disability and Prediction of Mortality and Nursing Home Admission. Journal of Gerontology, 49(2), M85–M94. https://doi.org/10.1093/geronj/49.2.M85
Imaizumi M, Sepulveda-Loyola W, Prado Gomes B, et al. Effects of novel multicomponent exercise programs on brain-derived neurotrophic factor levels and physical fitness in older women. Medwave, 25(4):e3010. doi:10.5867/medwave.2025.04.3010
Kwon, S., Perera, S., Pahor, M., Katula, J. A., King, A. C., Groessl, E. J. & Studenski, S. A. (2009). WHAT IS A MEANINGFUL CHANGE IN PHYSICAL PERFORMANCE? FINDINGS FROM A CLINICAL TRIAL IN OLDER ADULTS (THE LIFE-P STUDY). The Journal of Nutrition, Health & Aging, 13(6), 538. https://doi.org/10.1007/S12603-009-0104-Z
Lee, J. (2020). Associations Between Handgrip Strength and Disease-Specific Mortality Including Cancer, Cardiovascular, and Respiratory Diseases in Older Adults: A Meta-Analysis. Journal of Aging and Physical Activity, 28(2), 320–331. https://doi.org/10.1123/JAPA.2018-0348
Lemke, N. C., Werner, C., Wiloth, S., Oster, P., Bauer, J. M. & Hauer, K. (2019). Transferability and Sustainability of Motor-Cognitive Dual-Task Training in Patients with Dementia: A Randomized Controlled Trial. Gerontology, 65(1), 68–83. https://doi.org/10.1159/000490852
Loyola, W. S., Camillo, C. A., Torres, C. V. & Probst, V. S. (2018). Effects of an exercise model based on functional circuits in an older population with different levels of social participation. Geriatrics & Gerontology International, 18(2), 216–223. https://doi.org/10.1111/ggi.13167
Luppa, M., Luck, T., Weyerer, S., König, H. H., Brähler, E. & Riedel-Heller, S. G. (2010). Prediction of institutionalization in the elderly. A systematic review. Age and Ageing, 39(1), 31–38. https://doi.org/10.1093/AGEING/AFP202
Mahoney, F. I. & Barthel, D. W. (1965). FUNCTIONAL EVALUATION: THE BARTHEL INDEX. Maryland State Medical Journal, 14, 61–65. http://www.ncbi.nlm.nih.gov/pubmed/14258950
Mollinedo Cardalda, I., López, A. & Cancela Carral, J. M. (2019). The effects of different types of physical exercise on physical and cognitive function in frail institutionalized older adults with mild to moderate cognitive impairment. A randomized controlled trial. Archives of Gerontology and Geriatrics, 83, 223–230. https://doi.org/10.1016/J.ARCHGER.2019.05.003
Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Cummings, J. L. & Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695–699. https://doi.org/10.1111/j.1532-5415.2005.53221.x
Ottenbacher, K. J., Branch, L. G., Ray, L., Gonzales, V. A., Peek, M. K. & Hinman, M. R. (2002). The reliability of upper- and lower-extremity strength testing in a community survey of older adults. Archives of Physical Medicine and Rehabilitation, 83(10), 1423–1427. https://doi.org/10.1053/apmr.2002.34619
Pavasini, R., Guralnik, J., Brown, J. C., di Bari, M., Cesari, M., Landi, F., Vaes, B., Legrand, D., Verghese, J., Wang, C., Stenholm, S., Ferrucci, L., Lai, J. C., Bartes, A. A., Espaulella, J., Ferrer, M., Lim, J.-Y., Ensrud, K. E., Cawthon, P., … Campo, G. (2016). Short Physical Performance Battery and all-cause mortality: systematic review and meta-analysis. BMC Medicine, 14(1), 215. https://doi.org/10.1186/s12916-016-0763-7
Perera, S., Mody, S. H., Woodman, R. C. & Studenski, S. A. (2006). Meaningful change and responsiveness in common physical performance measures in older adults. Journal of the American Geriatrics Society, 54(5), 743–749. https://doi.org/10.1111/J.1532-5415.2006.00701.X
Prince, M. J., Acosta, D., Guerra, M., Huang, Y., Jacob, K. S., Jimenez-Velazquez, I. Z., Jotheeswaran, A. T., Llibre Rodriguez, J. J., Salas, A., Sosa, A. L., Acosta, I., Mayston, R., Liu, Z., Llibre-Guerra, J. J., Prina, A. M. & Valhuerdi, A. (2021). Intrinsic capacity and its associations with incident dependence and mortality in 10/66 Dementia Research Group studies in Latin America, India, and China: A population-based cohort study. PLOS Medicine, 18(9), e1003097. https://doi.org/10.1371/JOURNAL.PMED.1003097
Rezola-Pardo, C., Arrieta, H., Gil, S. M., Zarrazquin, I., Yanguas, J. J., López, M. A., Irazusta, J. & Rodriguez-Larrad, A. (2019). Comparison between multicomponent and simultaneous dual-task exercise interventions in long-term nursing home residents: the Ageing-ONDUAL-TASK randomized controlled study. Age and Ageing, 48(6), 817–823. https://doi.org/10.1093/AGEING/AFZ105
Rodriguez-Mañas, L., Laosa, O., Vellas, B., Paolisso, G., Topinkova, E., Oliva-Moreno, J., Bourdel-Marchasson, I., Izquierdo, M., Hood, K., Zeyfang, A., Gambassi, G., Petrovic, M., Hardman, T. C., Kelson, M. J., Bautmans, I., Abellan, G., Barbieri, M., Peña-Longobardo, L. M., Regueme, S. C., … European MID-Frail Consortium. (2019). Effectiveness of a multimodal intervention in functionally impaired older people with type 2 diabetes mellitus. Journal of Cachexia, Sarcopenia and Muscle, 10(4), 721–733. https://doi.org/10.1002/jcsm.12432
Sanchez-Sanchez, J. L., Carnicero-Carreño, J. A., Garcia-Garcia, F. J., Álvarez-Bustos, A., Rodríguez-Sánchez, B. & Rodríguez-Mañas, L. (2022). Physical performance measures in frailty screening: diagnostic and prognostic accuracy in the Toledo Study of Healthy Ageing. Maturitas, 165, 18–25. https://doi.org/10.1016/J.MATURITAS.2022.07.004
Sepúlveda-Loyola, W., Tricanico Maciel, R. P., de Castro Teixeira, D., Araya-Quintanilla, F., da Silva, R. A., Álvarez-Bustos, A., Mahmoud Smaili, S., Rodríguez-Mañas, L., Valenzuela- Fuenzalida, J. J., & Suziane Probst, V. (2025). Functional exercise circuit with dual task training on clinical outcomes related to sarcopenia in older adults: a nonrandomized controlled trial. Retos, 63, 459-471. https://doi.org/10.47197/retos.v63.110528
Silsupadol, P., Shumway-Cook, A., Lugade, V., van Donkelaar, P., Chou, L. S., Mayr, U. & Woollacott, M. H. (2009). Effects of Single-Task Versus Dual-Task Training on Balance Performance in Older Adults: A Double-Blind, Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation, 90(3), 381–387. https://doi.org/10.1016/j.apmr.2008.09.559
Tait, J. L., Duckham, R. L., Milte, C. M., Main, L. C. & Daly, R. M. (2017). Influence of Sequential vs. Simultaneous Dual-Task Exercise Training on Cognitive Function in Older Adults. Frontiers in Aging Neuroscience, 9. https://doi.org/10.3389/fnagi.2017.00368
United Nations. (2022). World Population Prospects 2022: Summary of Results.
Valenzuela, P. L., Saco-Ledo, G., Morales, J. S., Gallardo-Gómez, D., Morales-Palomo, F., López-Ortiz, S., Rivas-Baeza, B., Castillo-García, A., Jiménez-Pavón, D., Santos-Lozano, A., del Pozo Cruz, B. & Lucia, A. (2023). Effects of physical exercise on physical function in older adults in residential care: a systematic review and network meta-analysis of randomised controlled trials. The Lancet Healthy Longevity, 4(6), e247–e256. https://doi.org/10.1016/S2666-7568(23)00057-0
Varela-Vásquez, L. A., Minobes-Molina, E. & Jerez-Roig, J. (2020). Dual-task exercises in older adults: A structured review of current literature. Journal of Frailty, Sarcopenia and Falls, 05(02), 31–37. https://doi.org/10.22540/JFSF-05-031
Vasunilashorn, S., Coppin, A. K., Patel, K. V, Lauretani, F., Ferrucci, L., Bandinelli, S. & Guralnik, J. M. (2009). Use of the Short Physical Performance Battery Score to predict loss of ability to walk 400 meters: analysis from the InCHIANTI study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 64(2), 223–229. https://doi.org/10.1093/gerona/gln022
Vázquez González, D. H., Sangurima Pillco, L. M. & Estévez Abad, R. F. (2022). Validación de Montreal Cognitive Assessment (MoCA) en deterioro cognitivo. Cuenca, 2019. Revista de La Facultad de Ciencias Médicas de La Universidad de Cuenca, 40(2). https://doi.org/10.18537/RFCM.40.02.02
WHO | World report on ageing and health 2015. (2015). WHO. Retrieved May 14, 2025, http://www.who.int/ageing/events/world-report-2015-launch/en/
WHO guidelines on physical activity and sedentary behaviour. (2020). WHO. Retrieved May 14, 2025, from https://www.who.int/publications/i/item/9789240015128
Yu, X., Tengku Kamalden, T. F., Dev Omar Dev, R., Gasibat, Q., Rani, B., Dai, Y., Bao, L. & Li, J. (2023). Effects of Combining Physical and Cognitive Training on Older Adults’ Physical Performance and Functional Abilities: A Systematic Review. International Journal of Kinesiology and Sports Science, 11(2), 35–50. https://doi.org/10.7575/aiac.ijkss.v.11n.2p.35
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Copyright (c) 2025 Natalia Pinto-Rojas, Walter Sepúlveda-Loyola, Macarena Moyano-Fuentes, Constanza Arévalo-Cea, Katherine Agüero-Villa, Fabiola Briones-Pineda, Ignacio Astudillo-Ganora, Alejandro Álvarez-Bustos

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