Despite the global impact of neurodegenerative diseases and ongoing research efforts, pharmacological therapies have shown limited benefits. In contrast, physical exercise, with no side effects, has emerged as a non-pharmacological alternative that can enhance brain structure and function, promoting a healthier neurological phenotype.

This study aimed to explore the effects of aerobic and strength training methods, both with and without cognitive training, on mitigating or reversing cognitive decline in older adults.

In a randomized controlled trial, a total of 350 participants (average age 72.9±6.0 years, 79% female), with signs of decline (MoCA score below 26), were assigned to one of five groups: i) strength plus cognitive training (STCT, n=92); ii) strength training (ST, n=41); iii) aerobic training (AT, n=97); iv) aerobic plus cognitive training (ATCT, n=91); v) control (CG, n=29).

For 12 weeks, all groups followed a 60-minute training session three times a week, tailored to their specific group, with half of the sample adding 20 minutes of cognitive stimulation after the physical exercise.

Cognitive and physical assessments were conducted at the start and end of the intervention using the MoCA and the Senior Fitness test. A mixed ANCOVA analysis revealed significant interactions between time and group for all tests.

After the intervention, the CG showed significantly lower scores compared to all experimental groups. The CG also performed significantly worse than the ATCT group (p<0.001). Additionally, the ATCT outperformed the STCT in the 6-min walk test (p<0.05), while the STCT showed superior performance in the flexibility tests (sit and reach, back scratch) compared to the CG (p<0.05).

Results showed that 12-weeks of aerobic and strength training, with or without cognitive components, improved cognitive performance in older adults with cognitive decline, highlighting the importance of maintaining functional abilities for preserving skills, autonomy, independence, and quality of life in aging.