Baseline Global Cognitive Function Affects Cognitive and Functional Outcomes of Combined Physical and Cognitive Training Among Older Adults With Cognitive Decline

Importance: Baseline global cognitive function may affect cognitive and functional outcomes during combined physical and cognitive training; however, how it influences the effects of combined training remains uncertain. Objective: To determine the impact of baseline global cognitive function on cognitive and functional outcomes after combined physical and cognitive training among older adults with cognitive decline. Design: Observational. Setting: Local communities and senior centers. Participants: Older adults with mild cognitive decline (MCD; n 5 51) and moderate to severe cognitive decline (MSCD; n 5 40). Intervention: Participants received 45 to 55 min of physical exercise training followed by 45 to 55 min of cognitive training in one session per week for 12 wk. Outcomes and Measures: Montreal Cognitive Assessment (MoCA), Lawton–Brody Instrumental Activities of Daily Living Scale (Lawton–Brody IADL), Word Recall Test (WRT), Stroop Color and Word Test (SCWT), Digital Symbol Substitution Test (DSST), and Trail Making Test (TMT) scores were assessed and compared between the MCD and MSCD groups. Results: Significant interaction effects were found for the WRT, SCWT, MoCA, and Lawton–Brody IADL. WRT and SCWT scores significantly improved in the MCD group, whereas MoCA and Lawton–Brody IADL scores significantly improved in the MSCD group. DSST scores increased among all participants, but TMT scores improved only in the MCD group. Conclusions and Relevance: Older adults’ baseline global cognitive function affected cognitive and instrumental activities of daily living (IADL) outcomes regarding combined training. High-level cognitive function, including inhibition and shifting abilities and working memory capacity, improved among older adults with MCD, whereas general cognitive function and IADLs improved among older adults with MSCD.