The Study of Mental and Resistance Training (SMART) study—resistance training and/or cognitive training in mild cognitive impairment: a randomized, double-blind, double-sham controlled trial

• Published in: Journal of the American Medical Directors Association Vol. 15; no. 12; p. 873
• Main Authors: Fiatarone Singh, Maria A, Gates, Nicola, Saigal, Nidhi, Wilson, Guy C, Meiklejohn, Jacinda, Brodaty, Henry, Wen, Wei, Singh, Nalin, Baune, Bernhard T, Suo, Chao, Baker, Michael K, Foroughi, Nasim, Wang, Yi, Sachdev, Perminder S, Valenzuela, Michael
• Format: Journal Article
• Language: English
• Published: United States 01.12.2014
• Subjects: Activities of Daily Living; Aged; Cognitive Dysfunction - therapy; Double-Blind Method; Female; Humans; Male; Middle Aged; Neuropsychological Tests; Resistance Training - methods; Treatment Outcome; Mild cognitive impairment; resistance training; cognitive training
• ISSN: 1538-9375
• DOI: 10.1016/j.jamda.2014.09.010

Mild cognitive impairment (MCI) increases dementia risk with no pharmacologic treatment available. The Study of Mental and Resistance Training was a randomized, double-blind, double-sham controlled trial of adults with MCI. Participants were randomized to 2 supervised interventions: active or sham physical training (high intensity progressive resistance training vs seated calisthenics) plus active or sham cognitive training (computerized, multidomain cognitive training vs watching videos/quizzes), 2-3 days/week for 6 months with 18-month follow-up. Primary outcomes were global cognitive function (Alzheimer's Disease Assessment Scale-cognitive subscale; ADAS-Cog) and functional independence (Bayer Activities of Daily Living). Secondary outcomes included executive function, memory, and speed/attention tests, and cognitive domain scores. One hundred adults with MCI [70.1 (6.7) years; 68% women] were enrolled and analyzed. Resistance training significantly improved the primary outcome ADAS-Cog; [relative effect size (95% confidence interval) -0.33 (-0.73, 0.06); P < .05] at 6 months and executive function (Wechsler Adult Intelligence Scale Matrices; P = .016) across 18 months. Normal ADAS-Cog scores occurred in 48% (24/49) after resistance training vs 27% (14/51) without resistance training [P < .03; odds ratio (95% confidence interval) 3.50 (1.18, 10.48)]. Cognitive training only attenuated decline in Memory Domain at 6 months (P < .02). Resistance training 18-month benefit was 74% higher (P = .02) for Executive Domain compared with combined training [z-score change = 0.42 (0.22, 0.63) resistance training vs 0.11 (-0.60, 0.28) combined] and 48% higher (P < .04) for Global Domain [z-score change = .0.45 (0.29, 0.61) resistance training vs 0.23 (0.10, 0.36) combined]. Resistance training significantly improved global cognitive function, with maintenance of executive and global benefits over 18 months.