Objective To investigate the effect of functional task exercise on everyday problem-solving ability and functional status in older adults with mild cognitive impairment compared to single exercise or cognitive training and no treatment control. Design A single-blind, four-arm randomised controlled trial. Setting Out-patient clinic and community centre. Participants Older adults with mild cognitive impairment aged ≥60 living in community. Methods Participants (N = 145) were randomised to 8-week functional task exercise (N = 34), cognitive training (N = 38), exercise training (N = 37), or wait-list control (N = 36) group. Outcomes measures: Neurobehavioral Cognitive Status Examination, Category Verbal Fluency Test, Trail Making Test, Problems in Everyday Living Test, Activities of Daily Living Questionnaire, Instrumental Activities of Daily Living Scale; Chair stand test, Berg Balance Scale, and Short Form-12 Health Survey were conducted at baseline, post-intervention and 5-months follow-up. Results Post-intervention results of ANCOVA revealed cognitive training improved everyday problem-solving (P = 0.012) and exercise training improved functional status (P = 0.003) compared to wait-list control. Functional task exercise group demonstrated highest improvement compared to cognitive training, exercise training and wait-list control groups in executive function (P range = 0.003–0.018); everyday problem-solving (P < 0.001); functional status (P range = <.001–0.002); and physical performance (P = 0.008) at post-intervention, with all remained significant at 5-month follow-up, and further significant improvement in mental well-being (P = 0.043). Conclusions Functional task exercise could be an effective intervention to improve everyday problem-solving ability and functional status in older adults with mild cognitive impairment. The findings support combining cognitive and exercise intervention may give additive and even synergistic effects.

中文翻译：

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功能性任务锻炼对轻度认知障碍老年人日常问题解决能力和功能状态的影响——一项随机对照试验

目的 研究功能性任务锻炼对轻度认知障碍老年人日常问题解决能力和功能状态的影响，与单项锻炼或认知训练和无治疗对照相比。设计 一项单盲、四组随机对照试验。设置门诊和社区中心。参与者 居住在社区的 60 岁以上轻度认知障碍的老年人。方法 参与者 (N = 145) 被随机分为 8 周功能性任务锻炼 (N = 34)、认知训练 (N = 38)、运动训练 (N = 37) 或候补名单控制 (N = 36) 组。结果测量：神经行为认知状态检查，类别语言流利度测试，跟踪测试，日常生活中的问题测试，日常生活活动问卷，日常生活工具活动量表；在基线、干预后和 5 个月的随访中进行了椅子站立测试、Berg 平衡量表和 Short Form-12 健康调查。结果 ANCOVA 的干预后结果显示，与等待名单控制相比，认知训练改善了日常问题解决能力 (P = 0.012)，运动训练改善了功能状态 (P = 0.003)。与认知训练、运动训练和等待名单对照组相比，功能性任务锻炼组在执行功能方面的改善最大（P 范围 = 0.003-0.018）；日常问题解决（P < 0.001）；功能状态（P 范围 = <.001–0.002）；干预后的身体表现和身体表现（P = 0.008），在 5 个月的随访中均保持显着性，并且心理健康进一步显着改善（P = 0. 043). 结论 功能性任务锻炼是提高轻度认知障碍老年人日常问题解决能力和功能状态的有效干预措施。研究结果支持将认知和运动干预相结合可能会产生叠加甚至协同效应。