The effect of resistance training for older adults with cognitive frailty: a randomized controlled trial

Cognitive decline and the progression to dementia are hastened in individuals with cognitive frailty. Exercise interventions benefit cognitive function in patients with Mild Cognitive Impairment (MCI) or frailty. While the optimal implementation of resistance training for cognitive 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 cognitive frailty cohort. In this single-blind, randomized controlled trial, 68 individuals with MCI and frailty or pre-frailty were enrolled and allocated to either a resistance training program or a standard senior 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. 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 as measured by MoCA (F = 6.289, p = 0.011) and 4-meter walk time (F = 10.951, P = 0.002), with least squares mean difference of 1.299 (95% CI: 0.306 to 2.291) and − 0.576 (95% CI: -0.924 to -0.228), and with effect size of 0.095, 1.114, 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. Our study demonstrated that a hybrid online-offline resistance training model is safe and effective for older people with cognitive frailty, providing modest benefits over traditional exercises in enhancing global cognitive function, attention, physical function, and quality of life. ChiCTR2100043826 was registered on 4 March 2021.