The effects of physical exercise and cognitive activities on dementia risk reduction among elderly individuals with mild cognitive impairment

Abstract

Introduction: The elderly population in the world is increasing, not excluding Malaysia. This phenomenon is a significant concern as the rise of dementia cases is anticipated in the subsequent decades. Undoubtedly, the disease will have a detrimental effect on economics, society, and individuals. Physical exercise and cognitive interventions have been proven as potential risk reduction strategies in targeting high-risk groups known as mild cognitive impairment (MCI). Nevertheless, movement limitations among elderly have highlighted the necessity of remote delivery interventions, particularly in rural areas. This study aims to measure the effect of Aerobic exercise and Cognitive activities for Elderly (ACE) programme on the cognitive performance of elderly with MCI. Material and methods: A total of 87 participants completed the study, consisting of an experimental group (n = 43) and a control (n = 44) group. Participants in the experimental group received the ACE programme three times weekly over 12 weeks, whereas the control group received no intervention. The validated Mini-Cog instrument assessed the participants’ cognitive performance at three intervals: baseline, week 4, and week 12 post-intervention. Chi-square and independent t-tests were performed for univariate analysis, whereas generalised estimating equations were used for multivariate analysis to measure the score changes between baseline and post intervention within and between the two study groups. Results: The results demonstrated that the memory and clock drawing test scores were not significantly different between the experimental and control groups after four weeks (p > 0.05 for both groups). Interestingly, after 12 weeks, a significant difference in memory scores and clock drawing test scores between the experimental and control groups were observed (p = 0.003) and (p = 0.045), respectively. After adjusting the confounders, multivariate analyses showed that the experimental group was significantly improved in both memory (p = 0.036) and clock drawing test (p = 0.041) scores compared to the control group, with 2.322 and 2.360 times more likely to improve the scores, respectively. A significant association between assessment time and cognitive performance was also observed, showing that 12 weeks of intervention significantly improved memory (p < 0.001) and clock drawing test (p = 0.035) scores compared to four weeks. Conclusion: The ACE programme had improved cognitive performance among the elderly with MCI, showing that implementation of physical and cognitive leisure activities at the community level may help to delay the progression of dementia among the FELDA elderly. Simultaneously, the selection of activities that can be performed at home may be a practical, inexpensive, safe, and convenient option for the elderly population in rural areas.