Number of chronic diseases moderates the association between cognitive training and mobility among older adults

Chronic diseases (CD) can seriously affect older adults’ quality of life through increased risk for depression, cognitive decline, and mobility disorders. Both type 2 diabetes and hypertension are linked to significant cognitive decline.  A separate literature provides evidence that cognition plays an important role in mobility, including balance and gait.  The purpose of this study was to determine whether the number of CDs moderates the impact of cognitive training (CT) on mobility.  

Participants (N=45) were recruited to test the hypothesis that a community-based 10-week CT intervention improves gait and balance in older adults.  Participants were randomly assigned to CT or control.  Outcomes, measured at baseline and 10 weeks, included gait speed, Timed Up and Go (TUG), and Berg Balance Scale (BBS).  Repeated measures models were used to determine whether there were significant changes in outcomes by study arm among participants with high (4+) or low/moderate (3 or fewer) co-morbid CDs.

Participants (N=45) had an average age of 72.5. Compared to controls, intervention participants with low/moderate CD exhibited significant improvement in gait speed (F(1,19)=7.86,p=.011)  and BBS (F(1,20)=4.35, p=0.50), whereas those with high CD did not.  Compared to controls, TUG also improved for intervention participants with low/moderate CD while it worsened for participants with high CD, although these differences did not reach significance. 

Results from this study demonstrate the influence the number of CD can have on individuals’ mobility, perhaps due to the link between CD and cognitive decline.  Larger trials are needed to confirm the moderating effect of CD on mobility.