Integrating Cognitive Training Into Exercise Programs for Older Adults
Improve the cognitive function of your older adult clients by mixing mental exercise with physical movement.
Exercise is good for the aging brain. Indeed, the right kind of exercise can protect against neurodegeneration, the natural decline of brain functions that accompanies aging.
Scientists have found that older adults can benefit from effortful learning, which combines mental exercises with physical movement. Effortful exercises include learning to speak a new language, playing a musical instrument, performing dance steps or tai chi, or even figuring out how to juggle.
The key to effortful learning seems to be that the tasks are novel and challenging (Bamidis et al. 2015). Learning a new skill can release beneficial neurotransmitters such as dopamine and acetylcholine, which may accelerate neuroplasticity, the brain’s ability to adapt to new challenges.
So, how can you “cognify” exercises to give your clients a big kick in the hippocampus? The basic ideas here can help you integrate cognitive stimuli into most exercises.
Cognitive Exercise Basics
When you’re working with older adults, pay close attention to safety and cognitive load, keeping in mind acute variables in speed, duration, load, environment and direction. Ideally, the client already knows how to do certain movements. This knowledge provides a safe starting point from which to add layers of cognitive cues.
Remember that you need to link the cognitive task to the physical task. For instance, you might ask clients to calculate math problems while squatting or recite poetry while walking on
The following cognitive-physical exercise examples use the familiar lunge motion, but you can adapt any movement with stepping or reaching (even in multiple directions). Don’t worry that lunges are strength training movements. The main idea is to get clients to perform enough repetitions to increase their heart rate.
Many studies report improvement in cognitive outcomes at 60%–75% of the individual’s maximum heart rate. Some studies suggest higher intensity or maximal training is more effective, but before you add dual-task techniques at higher intensities, make sure you assess the client’s cardiovascular fitness.
Keep in mind that the client’s rating of perceived exertion reflects the complexity or difficulty of dual-task exercises. Also, strive for postural control and completion of the task with at least 75% movement accuracy. If a client can’t meet these guidelines, you’ll probably have to reduce the complexity of the task and/or aerobic load.
Using the Limbs
This exercise, which uses simple, fun cognitive cues, involves reasoning and memory. As the trainer, you call out a kind of food, and the client identifies whether it’s a vegetable or a fruit—and then moves accordingly. Example: When the client hears you say “apple,” she lunges, leading with the left foot because it’s a fruit. When you call out “carrot,” her lunge leads with the right foot because it’s a vegetable.
As the client’s proficiency with this cognitive load improves, call out the words more quickly or offer compound lists (quickly stating a fruit, another fruit, a vegetable and then a fruit, for example), challenging the client to remember the sequence.
Starting with a list can be helpful. Just make sure it does not become so predictable that clients can learn the pattern.
Select two balls with different colors (ideally tennis balls or tennis balls with different colored markings or tape on them). Assign each color to a client’s hand—for example, blue ball = right hand; pink ball = left hand.
Then throw either ball. The client must catch it with the appropriate hand, which challenges processing speed and impulse control. Progress the drill by instructing the client to perform a balance exercise or alternating lunges while responding to the correct ball.
Keep a tally of incorrect choices to encourage better attention and to reward improved engagement.
Flows of Exercise
Using a functional loaded implement (or body weight), demonstrate a chain of two to five exercises the client must memorize and execute. Most clients will ask you to clarify the exercise sequence until they are perfectly clear. Tell them you will demonstrate it only once to encourage careful attention and challenge memory.
Provide feedback at the end of the set. Progress by adding different, longer, more complex or faster movement sequences. Examples you can tweak for memory purposes include Animal Flow®, ViPR® flows, tai chi, Zumba® moves or yoga flows.
For more on this topic, see “Boosting the Brain Health of Older Adults” the online IDEA Library or in the January 2019 print edition of IDEA Fitness Journal. If you cannot access the full article and would like to, please contact the IDEA Inspired Service Team at 800-999-4332, ext. 7.