Cognitive Training and Vitamin D May Enhance Cognition among Elderly: JAMA

A recent clinical trial known as the SYNERGIC Study has revealed promising results indicating that a multidomain intervention involving aerobic-resistance exercise, cognitive training, and vitamin D supplementation may significantly enhance cognition in older adults suffering from mild cognitive impairment (MCI). The findings were published in the Journal of American Medical Association.

The randomized clinical trial involved participants between the ages of 65 and 84 years with mild cognitive impairment, enrolled from September 19, 2016, to April 7, 2020. A total of 175 participants, including 86 women, were randomly assigned to one of five study arms and underwent treatment for 20 weeks.

The five study arms were:

Multidomain intervention with exercise, cognitive training, and vitamin D

Exercise, cognitive training, and placebo vitamin D

Exercise, sham cognitive training, and vitamin D

Exercise, sham cognitive training, and placebo vitamin D

Control group with balance-toning exercise, sham cognitive training, and placebo vitamin D

The vitamin D regimen involved a 10,000 IU dose administered three times weekly. Primary outcomes were measured using the ADAS-Cog-13 and ADAS-Cog-Plus variant at the 6-month mark.

The results of the trial demonstrated that all active arms (arms 1 through 4) with aerobic-resistance exercise, regardless of the presence of cognitive training or vitamin D supplementation, exhibited significant improvement in ADAS-Cog-13 when compared with the control group (mean difference, −1.79 points; 95% CI, −3.27 to −0.31 points; P = .02; d = 0.64).

Moreover, participants who underwent both exercise and cognitive training (arms 1 and 2) showed even greater improvement in ADAS-Cog-13 compared to those who underwent exercise alone (arms 3 and 4) (mean difference, −1.45 points; 95% CI, −2.70 to −0.21 points; P = .02; d = 0.39). However, the study found that vitamin D supplementation did not have a significant effect on cognitive improvement.

The multidomain intervention (arm 1) involving exercise, cognitive training, and vitamin D demonstrated the most promising results, significantly improving the ADAS-Cog-13 score compared to the control group (mean difference, −2.64 points; 95% CI, −4.42 to −0.80 points; P = .005; d = 0.71).

While some results were inconsistent, the overall implications of the SYNERGIC Study are highly encouraging. It suggests that older adults with mild cognitive impairment may experience enhanced cognition and a potential delay in the onset of dementia through the implementation of a comprehensive approach combining aerobic-resistance exercises with sequential computerized cognitive training.

Source:

Montero-Odasso, M., Zou, G., Speechley, M., Almeida, Q. J., Liu-Ambrose, T., Middleton, L. E., Camicioli, R., Bray, N. W., Li, K. Z. H., Fraser, S., Pieruccini-Faria, F., Barha, C., & McGibbon, C. (2023). Effects of Exercise Alone or Combined With Cognitive Training and Vitamin D Supplementation to Improve Cognition in Adults With Mild Cognitive Impairment. In JAMA Network Open. American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.24465