The effect of “Cognitive Task Switching” training program on Balance and Cognitive performances in older adults, Tabriz

Abstract

Background: According to the importance of successful aging, this study designed to evaluate the effect of “Task-Switching” training program on Balance and Cognitive performances in older adults as an essential dimension of successful aging. Material and methods: The methodology is divided in two parts: a systematic review and a clinical trial. In the systematic review section, a systematic search was conducted in Web of Science, Pubmed, Embase, Scopus, and Proquest databases to identifying physical and mental task on cognition and balance functions. After a systematic search among articles published between 2000 to 2020, 18 clinical trial studies were identified. The identified effective physical exercises included internal walking, square-stepping exercise, Tai Chi Chuan, walking, balance-strength exercises, Feldenkrais, Turkish folk dance and yoga. The identified mental tasks includes memorization tasks, math-literature tasks, executive function training, the first set of various mental tasks (such as: decoding symbols and solving crosswords), Brain age program, working memory tasks, the set of self-help memory tasks (such as: matching appearance features with names) and the second set of various mental tasks (such as: identifying opposite words, drawing images of rituals). The studies extracted from this stage were used to design the training program for the physical, mental and physical-mental task-switching groups. The clinical trial section was conducted on older adults who referred to age-friendly centers in Tabriz. Seventy seven older adults were randomly assigned to four physical, mental, physical-mental task-switching and control groups. The intervention was presented in 24 sessions and 3 times a week. The control group continued their daily activities. Activity card sorting questionnaire, Fullerton advanced balance test, Trail Making Test A-B, Wisconsin card sorting test, N-Back test, Stroop test and divided attention test before the intervention, one week, one month and three month after the intervention was completed. Findings: The findings of the present study show a significant improvement in the physical-mental task-switching group compared to the control group for the Fullerton tests (P<0.001), TMT-A (P<0.05), TMT-B (P<0.001) and the divided attention test (P<0.001). In the physical group, compared to the control group, there was a significant improvement in Fullerton test (P<0.001), N-Back test (P<0.05), TMT-B (P<0.001), and divided attention test (P≤0.001). In the mental group, the only significant improvement compared to the control group was the divided attention test (P<0.05). Conclusion: The results of the present study show the important role of physical exercises single or in combination with mental tasks in task-switching paradigm in improving balance performance and a wide range of cognitive functions. Therefore, it is recommended to older adults use physical and physical-mental task-switching program to enrich leisure time and maintain balance and cognitive abilities as the most important components of successful aging.