The combination of exercise and cognitive training provided modest benefit in a small, randomised trial.

Various interventions, including aerobic or resistance exercise and cognitive training, benefit patients with mild cognitive impairment. Vitamin D supplementation also has been suggested to be beneficial. Canadian investigators explored various combinations of these three interventions by randomising 175 older adults (mean age, 73 years; mean baseline vitamin D level, 75 to 87 nmol/L) with mild cognitive impairment to five arms. In four groups, all participants received aerobic/resistance exercise training plus either cognitive training or sham cognitive training, and either vitamin D or placebo. The fifth group was a control group.

All groups met three times weekly (150 minutes per session) for 20 weeks. At six months, groups who received supervised exercise, with or without cognitive training, improved significantly more than the control group (by one to two points more on an 85-point cognitive function scale). The group that received all three interventions improved by almost three points more than the control group. Vitamin D did not provide incremental benefit. 

Comment: Although the magnitude of benefit was small, these results might help clinicians counsel patients with mild cognitive impairment. The focus should be on combining structured exercise programs (aerobic, resistance, or both) with cognitive training.

Thomas L. Schwenk, MD, Professor Emeritus, Family and Community Medicine, University of Nevada School of Medicine, Reno, USA.

Montero-Odasso M, et al. Effects of exercise alone or combined with cognitive training and vitamin D supplementation to improve cognition in adults with mild cognitive impairment: a randomized clinical trial. JAMA Netw Open 2023; 6: e2324465.

This summary is taken from the following Journal Watch titles: General Medicine, Ambulatory Medicine, Neurology.