Synergistic effects of exercise, cognitive training and vitamin D on gait performance and falls in mild cognitive impairment—secondary outcomes from the SYNERGIC trial
Bibliographic record
Abstract
BACKGROUND: Older adults with mild cognitive impairment (MCI) have a higher risk of gait impairments and falls; yet, the effects of multimodal interventions, including combinations of exercises with cognitive training, on improving their mobility remain unclear. OBJECTIVES: To investigate the synergistic effects of aerobic-resistance exercise combined with cognitive training, with or without vitamin D supplementation, on gait performance and falls risk in older adults with MCI. METHODS: The effect of 20 weeks of aerobic-resistance exercise, cognitive training, and Vitamin D supplementation (10 000 IU 3×/week) on gait and falls in older adults with MCI was evaluated in the SYNERGIC trial, using a fractional factorial design. Assessments were conducted at baseline, 6-month endpoint (after intervention) and 12-month endpoint (follow-up). Eligible participants were between the ages of 65 and 84 years with MCI enrolled from 19 September 2016 to 7 April 2020. Main outcomes of interest for gait performance were gait speed and gait variability changes, whilst for falls were incidental falls and incidental injurious falls. RESULTS: Amongst 161 participants, the four exercise-based arms improved gait speed (+7.5 cm/s, P < .001) and reduced falls (incidence rate ratios (IRR) = 0.65, 95% confidence interval (CI): 0.32-1.42, P = .25) and injurious falls (IRR = 0.38, 95% CI: 0.15-1.05, P = .05) at 6-month endpoint. Falls reduction reached statistical significance (IRR = 0.28, 95% CI: 0.13-0.64, P = .002) at 12-month endpoint. Exercises combined with cognitive training showed the greatest gains in gait speed at 6-month endpoint (P < .001) and in reducing falls at 12-month endpoint (IRR = 0.24, 95% CI: 0.05-0.77, P = .02) compared to the control. Vitamin D did not enhance outcomes and increased gait variability, a marker of instability. CONCLUSION: Aerobic-resistance exercise combined with sequential computerised cognitive training improved gait performance at 6 months and decreased the risk of falls and injuries at 12 months in older adults with MCI. The addition of vitamin D did not produce benefits.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".