Virtual bike tour, exercise game combat mild cognitive impairment in small study

By Dave Muoio
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of seniors with mild cognitive impairment suggested that pairing regular exercise with mental stimuli — in this case, screens depicting a virtual bike ride or an exercise-driven video game — could lead to greater cognitive benefits than prescribed exercise alone.

As the final qualifying sample consisted of just 14 seniors, however, the researchers noted that a larger randomized controlled trial would be necessary to confirm the results.

"It's promising data," Cay Anderson-Hanley, associate professor of psychology at Union College and the study's lead author, said in a statement. “‘Exergaming' is one more thing that could be added to the arsenal of tools to fight back against this cruel disease."

The new study builds on previous work by Anderson-Hanley and others, which observed this effect among a sample of seniors without cognitive impairment, as well as other pilot data suggesting that increasing the intensity of a mental challenge could lead to greater cognitive benefits.

To investigate these effects among those with mild cognitive impairment, Anderson-Hanley and colleagues recruited older adults screened for impairment to randomly complete a six-month exercise bike regimen complimented with either a screen displaying a scenic virtual bike path or an interactive, score-driven game powered by players’ pedaling. After the six-months, researchers compared executive function scores — a measure of neurologic skills involving mental control and self regulation — between these two groups, as well as to another group given a video game with no exercise.

"The goal is to explore even more effective ways to prevent or ameliorate cognitive decline in older adults by tailoring accessibility and level of mental engagement in interactive cognitive and physical exercise," Anderson-Hanley said.

Although 111 participants were evaluated and randomized, only 14 met the study’s minimum compliance requirement at the end of the study period. These participants were equally distributed between the two main study groups, with an average age of 78 years.

While the researchers predicted that those playing the more mentally challenging exercise video game would demonstrate better results, both groups showed evidence of cognitive function improvement. Further, the virtual tour appeared to yield benefits sooner than both the exercise game and the exercise-less game did, an effect that the researchers hypothesized might have to do with the game’s increased difficulty and barrier of entry.

These results suggest that mild cognitive impairment could be mitigated by a combination of physical and mental exertion, which could potentially be delivered through tech-enabled methods such as those employed in the study. Still, the researchers cautioned that the small study population limits the validity of these findings.

“The resultant small sample does diminish statistical power, although despite this, effects were sizeable enough to detect. Additionally, a small sample limits our ability to ask nuanced questions of the dataset which the study design would have facilitated if a larger sample had been obtained,” they wrote. “Nevertheless, much was learned regarding the needs of [mild cognitive impairment] patients and families in the conduct of such a trial, and will enhance future trial designs and interventions.”