Adherence and aerobic exercise intensity in live online exercise sessions for older adults with mild cognitive impairment: Insights from the Japan-Multimodal Intervention Trial for the Prevention of Dementia - 07/02/25

Doi : 10.1016/j.jarlif.2025.100003

Taiki Sugimoto ^a,^b,^⁎ , Kazuaki Uchida ^b, Yoko Yokoyama ^b, Ayaka Onoyama ^b, Kosuke Fujita ^b, Yujiro Kuroda ^b, Keigo Hinakura ^c, Susumu Ogawa ^c, Hiroyuki Suzuki ^c, Yoshinori Fujiwara ^d, Paul K Crane ^a, Hidenori Arai ^e, Takashi Sakurai ^b,^f,^g
J-MINT study group
^a Department of Medicine, University of Washington, Seattle, Washington, USA
^b Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
^c Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo
^d Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo
^e National Center for Geriatrics and Gerontology, Obu, Japan
^f Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
^g Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Nagoya, Japan

^⁎Corresponding author.

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Abstract

Background

Intervention adherence is crucial to ensure cognitive benefits in trials designed to prevent cognitive decline. During the coronavirus disease 2019 (COVID-19) pandemic, the Japan-Multimodal Intervention Trial for the Prevention of Dementia offered live online exercise sessions to older adults with mild cognitive impairment (MCI).

Objectives

To assess adherence and aerobic exercise intensity through live online exercise sessions in older adults with MCI.

Design

Posthoc analysis of the 18-month, multi-center, randomized controlled trial.

Setting

The study was conducted across five institutions in Japan.

Participants

Older adults aged 65–85 years who were assigned to the intervention group and completed the intervention. Participants were stratified by region (Aichi and Tokyo), where the state of emergency duration due to COVID-19 varied.

Interventions

The intervention group participated in multidomain interventions, including 90-minute group-based physical exercise sessions held weekly for 78 sessions. During the state of emergency, live online sessions were conducted via video conferencing.

Measurements

Attendance rates and aerobic exercise intensity (based on heart rates) during online and onsite sessions were compared using the Wilcoxon signed-rank test.

Results

A total of 207 participants were analyzed. Over 18 months, 78 exercise sessions were conducted, including live online sessions. In the Aichi region, 2 online sessions were held, while in the Tokyo region, 24 online sessions were conducted. In the Tokyo region, adherence was higher in online sessions compared to onsite sessions (92 % vs. 86 %, p = 0.046), while exercise intensity showed no significant difference (49 % vs. 52 %, p = 0.279). No adverse events were reported.

Conclusions

Live online exercise sessions were safe, feasible, and demonstrated adherence and intensity comparable to onsite sessions.

Trial registration

The trial was registered at the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) on November 24, 2019 (UMIN000038671) (ctr_view.cgi?recptno=R000044075).

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Keywords : Multidomain intervention, Exercise, Adherence, Online, Mild cognitive impairment