Psychosocial outcomes following dual-task high-velocity exercise training in older adults: A secondary analysis of an 18-month cluster randomised controlled trial

Objectives Power and resistance training can improve older adults’ perceived health, and while cognitive training has mixed benefits, combined effects remain uncertain. This secondary analysis of an 18-month cluster randomised controlled trial investigated whether dual-task functional power training (DT-FPT) improves psychosocial outcomes in older adults at risk for falls. Methods Twenty-two independent-living retirement communities (300 residents, ≥65 years) were randomised to 12 months of group-based DT-FPT (6 months supervised + 6 months maintenance; 2/week, 45-60 minutes) performed with cognitive and/or motor tasks or control (CON), followed by a 6-month follow-up. Health-related quality of life (HR-QoL; SF-36v2), life satisfaction (Personal Wellbeing Index), and psychological distress (Depression Anxiety and Stress Scale [DASS-21]) were assessed at baseline, 6, 12, and 18 months, generating subscale, summary, and composite scores. Results Overall, 227 (76%) participants provided data at the 18-month follow-up; mean exercise adherence was 50% at 6 months and 40% at 12 months. At 6 months, DT-FPT showed net benefits compared to CON for physical functioning (1.77 points [95% CI: 0.03, 3.51]; p = 0.047), role-physical (2.71 [0.35, 5.08]; p = 0.025), and role-emotional (2.25 [0.09, 4.40]; p = 0.041) HR-QoL domains. No changes were observed in life satisfaction or psychological distress, but CON showed lower Anxiety DASS-21 subscale scores than DT-FPT at 12 months (-2.0 [-3.22, -0.76]; p = 0.001) and 18 months (-0.93 [-1.84, -0.02]; p = 0.045). Discussion DT-FPT delivered to older, retirement-living adults at risk of falls may improve select HR-QoL domains, potentially reducing perceived physical limitations in daily activities, but shows no sustained effects or impact on life satisfaction.