The Effect of Resistance Training for Elderly with Mild Cognitive Impairment and Frailty: A Randomized Controlled Trial

Abstract Background: Cognitive decline and the progression to dementia are hastened in individuals with Mild Cognitive Impairment (MCI) and frailty. Exercise interventions benefit cognitive function in patient with MCI. While the optimal implementation of resistance training for MCI and frailty is still being explored. The aims of this study were to develop and evaluate the effect of a novel, hybrid online-offline resistance training regimen for the MCI and frailty cohort. Methods: In this double-blind, randomized controlled trial, 68 elderly individuals with MCI and frailty were enrolled and allocated to either a resistance training program or a standard elderly fitness exercise regimen. The resistance training, designed based on the intervention mapping framework, comprised a 12-week hybrid intervention, blending online and offline sessions, conducted three times a week. The primary outcomes measured were global cognitive function and physical function. Data analysis was conducted meticulously using covariance analysis, with a commitment to the intention-to-treat principle. Results: The hybrid online-offline resistance training regimen was both safe and feasible. Participants in the resistance training group exhibited significantly greater improvements in global cognitive function (F=6.289, p=0.011) and 4-meter walk time (F=10.951, P=0.002), with effect sizes of 1.299 (95% CI: 0.306 to 2.291) and -0.576 (95% CI: -0.924 to -0.228), respectively. Furthermore, resistance training proved more effective in boosting attention and enhancing quality of life. Between the groups, no significant differences were noted in executive, language, and memory functions, as well as in measures of anxiety, depression, and self-efficacy, among other aspects. Conclusions: Our study demonstrated that a hybrid online-offline resistance training model is safe and effective for elderly with MCI and frailty, showing superior benefits over traditional exercises in enhancing global cognitive function, attention, physical function and quality of life. Trial registration: ChiCTR2200057685 was registered on 04/03/2021.