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http://dx.doi.org/10.22683/tsnr.2021.10.3.023

A Systematic Review and Meta-Analysis of the Effects of Simultaneous Dual-Task Training on Executive Function in Older Adults  

Jeun, Yu-Jin (Dept. of ICT Convergence, The Graduate School, Soonchunhyang University)
Park, Jin-Hyuck (Dept. of Occupational Therapy, Soonchunhyang University)
Publication Information
Therapeutic Science for Rehabilitation / v.10, no.3, 2021 , pp. 23-41 More about this Journal
Abstract
Objective : The purpose of this study was to analyze the effects of simultaneous dual-task training to assess executive function in older adults. Methods : We searched the PubMed, EMBASE, Cochrane, Web of Science, and RISS databases of publicated studies in the past decade. Seven studies were selected based on the inclusion and exclusion criteria. Qualitative assessment and meta-analysis were performed for the seven studies. Results : A randomized controlled trial design was used in the selected studies, and PEDro Scores above seven were obtained. The Trial Making Test (TMT) evaluated the effects of dual-task training on executive function in four studies. The Color Trail Test (CTT) was used in two studies, and Stroop test was used in three studies. The effect size for total executive function was 0.38, which was small. The effect sizes for TMT and CTT were 0.37. Stroop Test was 0.34, demonstrating that their effect sizes were also small. Only significant effects in total executive function, TMT, and CTT showed significant effects (all p<0.05). Conclusion : This study confirmed that dual-task training was effective in improving executive function in older adults. To improve the effectiveness of dual-task training, the difficulty of the dual-task training should be considered. It is also necessary to implement assessments that can evaluate performance under dual-task conditions as well as conventional test tools for executive function. In the future, dual-task training could be used as an appropriate intervention for executive function in older adults to delay the onset of dementia.
Keywords
Dual-task training; Executive function; Meta-analysis; Older adults;
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1 Egeland, J., & Langfjaeran, T. (2007). Differentiating malingering from genuine cognitive dysfunction using the Trail Making Test-ratio and Stroop Interference scores. Applied Neuropsychology, 14(2), 113-119. doi:10.1080/09084280701319953   DOI
2 Falbo, S., Condello, G., Capranica, L., Forte, R., & Pesce, C. (2016). Effects of physical-cognitive dual task training on executive function and gait performance in older adults: A randomized controlled trial. BioMed Research International, 2016, 1-13. doi:10.1155/2016/5812092   DOI
3 Fissler, P., Kuster, O., Schlee, W., & Kolassa, I. T. (2013). Novelty interventions to enhance broad cognitive abilities and prevent dementia: Synergistic approaches for the facilitation of positive plastic change. In Progress in Brain Research, 207, 403-434. doi:10.1016/B978-0-444-63327-9.00017-5   DOI
4 Funahashi, S. (2001). Neuronal mechanisms of executive control by the prefrontal cortex. Neuroscience Research, 39(2), 147-165. doi:10.1016/S0168-0102(00)00224-8   DOI
5 Gheysen, F., Poppe, L., DeSmet, A., Swinnen, S., Cardon, G., De Bourdeaudhuij, I., ... Fias, W. (2018). Physical activity to improve cognition in older adults: Can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 15(1), 1-13. doi:10.1186/s12966-018-0697-x   DOI
6 Gill, D. P., Gregory, M. A., Zou, G., Liu-Ambrose, T., Shigematsu, R., Hachinski, V., ... Petrella, R. (2015). The healthy mind, healthy mobility trial: A novel exercise program for older adults. Medicine & Science in Sports & Exercise, 48(2), 297-306. doi:10.1249/MSS.0000000000000758   DOI
7 Oosterman, J. M., Vogels, R. L., van Harten, B., Gouw, A. A., Poggesi, A., Scheltens, P., ... Scherder, E. J. (2010). Assessing mental flexibility: Neuroanatomical and neuropsychological correlates of the Trail Making Test in elderly people. The Clinical Neuropsychologist, 24(2), 203-219. doi:10.1080/13854040903482848   DOI
8 Pellecchia, G. L. (2005). Dual-task training reduces impact of cognitive task on postural sway. Journal of Motor Behavior, 37(3), 239-246. doi:10.3200/JMBR.37.3.239-246   DOI
9 Anderson-Hanley, C., Arciero, P. J., Brickman, A. M., Nimon, J. P., Okuma, N., Westen, S. C., ... Zimmerman, E. A. (2012). Exergaming and older adult cognition: A cluster randomized clinical trial. American Journal of Preventive Medicine, 42(2), 109-119. doi:10.1016/j.amepre.2011.10.016   DOI
10 Park, H., Park, J. H., Na, H. R., Hiroyuki, S., Kim, G. M., Jung, M. K., ... Park, K. W. (2019). Combined intervention of physical activity, aerobic exercise, and cognitive exercise intervention to prevent cognitive decline for patients with mild cognitive impairment: A randomized controlled clinical study. Journal of Clinical Medicine, 8(7), 1-12. doi:10.3390/jcm8070940   DOI
11 Raichlen, D. A., Bharadwaj, P. K., Nguyen, L. A., Franchetti, M. K., Zigman, E. K., Solorio, A. R., & Alexander, G. E. (2020). Effects of simultaneous cognitive and aerobic exercise training on dual-task walking performance in healthy older adults: Results from a pilot randomized controlled trial. BMC Geriatrics, 20(1), 1-10. doi:10.1186/s12877-020-1484-5   DOI
12 Hiyamizu, M., Morioka, S., Shomoto, K., & Shimada, T. (2012). Effects of dual task balance training on dual task performance in elderly people: A randomized controlled trial. Clinical Rehabilitation, 26(1), 58-67. doi:10.1177/0269215510394222   DOI
13 Hwang, S. D. (2016). Publication bias in meta-analysis: Its meaning and analysis. Korean Journal Human Development, 23(1), 1-19. doi:10.15284/kjhd.2016.23.1.1   DOI
14 He, Y., Yang, L., Zhou, J., Yao, L., & Pang, M. Y. C. (2018). Dual-task training effects on motor and cognitive functional abilities in individuals with stroke: A ystematic review. Clinical Rehabilitation, 32(7), 865-877. doi:10.1177/0269215518758482   DOI
15 Plummer-D'Amato, P., Brancato, B., Dantowitz, M., Birken, S., Bonke, C., & Furey, E. (2012). Effects of gait and cognitive task difficulty on cognitive-motor interference in aging. Journal of Aging Research, 2012, 1-9. doi:10.1155/2012/583894   DOI
16 Rahe, J., Becker, J., Fink, G. R., Kessler, J., Kukolja, J., Rahn, A., ... Kalbe, E. (2015). Cognitive training with and without additional physical activity in healthy older adults: Cognitive effects, neurobiological mechanisms, and prediction of training success. Frontiers in Aging Neuroscience, 7, 1-15. doi:10.3389/fnagi.2015.00187   DOI
17 Scarpina, F., & Tagini, S. (2017). The stroop color and word test. Frontiers in Psychology, 8, 1-8. doi:10.3389/fpsyg.2017.00557   DOI
18 Moseley, A. M., Herbert, R. D., Sherrington, C., & Maher, C. G. (2002). Evidence for physiotherapy practice: A survey of the Physiotherapy Evidence Database (PEDro). Australian Journal of Physiotherapy, 48(1), 43-49. doi:10.1016/S0004-9514(14)60281-6   DOI
19 Ohsugi, H., Ohgi, S., Shigemori, K., & Schneider, E. B. (2013). Differences in dual-task performance and prefrontal cortex activation between younger and older adults. BMC Neuroscience, 14(1), 1-9. doi:10.1186/1471-2202-14-10   DOI
20 Poulin, V., Korner-Bitensky, N., Dawson, D. R., & Bherer, L. (2012). Efficacy of executive function interventions after stroke: A systematic review. Topics in Stroke Rehabilitation, 19(2), 158-171. doi:10.1310/tsr1902-158   DOI
21 Cahn-Weiner, D. A., Boyle, P. A., & Malloy, P. F. (2002). Tests of executive function predict instrumental activities of daily living in community-dwelling older individuals. Applied Neuropsychology, 9(3), 187-191. doi:10.1207/S15324826AN0903_8   DOI
22 Yokoyama, H., Okazaki, K., Imai, D., Yamashina, Y., Takeda, R., Naghavi, N., ... Miyagawa, T. (2015). The effect of cognitive-motor dual-task training on cognitive function and plasma amyloid β peptide 42/40 ratio in healthy elderly persons: A randomized controlled trial. BMC Geriatrics, 15(1), 1-10. doi:10.1186/s12877-015-0058-4   DOI
23 Zhu, X., Yin, S., Lang, M., He, R., & Li, J. (2016). The more the better? A meta-analysis on effects of combined cognitive and physical intervention on cognition in healthy older adults. Ageing Research Reviews, 31, 67-79. doi:10.1016/j.arr.2016.07.003   DOI
24 Knaepen, K., Goekint, M., Heyman, E. M., & Meeusen, R. (2010). Neuroplasticity-exercise-induced response of peripheral brain-derived neurotrophic factor. Sports Medicine, 40(9), 765-801. doi:10.2165/11534530-000000000-00000   DOI
25 Grober, E., Hall, C. B., Lipton, R. B., Zonderman, A. B., Resnick, S. M., & Kawas, C. (2008). Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease. Journal of the International Neuropsychological Society, 14(2), 266-278. doi:10.1017/S1355617708080302   DOI
26 Anderson-Hanley, C., Maloney, M., Barcelos, N., Striegnitz, K., & Kramer, A. (2017). Neuropsychological benefits of neuro-exergaming for older adults: A pilot study of an interactive physical and cognitive exercise system (iPACES). Journal of Aging and Physical Activity, 25(1), 73-83. doi:10.1123/japa.2015-0261   DOI
27 Arbuthnott, K., & Frank, J. (2000). Trail Making Test, part B as a measure of executive control: Validation using a set-switching paradigm. Journal of Clinical and Experimental Neuropsychology, 22(4), 518-528. doi:10.1076/1380-3395(200008)22:4;1-0;FT518   DOI
28 Barcelos, N., Shah, N., Cohen, K., Hogan, M. J., Mulkerrin, E., Arciero, P. J., ... Anderson-Hanley, C. (2015). Aerobic and Cognitive Exercise (ACE) pilot study for older adults: Executive function improves with cognitive challenge while exergaming. Journal of the International Neuropsychological Society: JINS, 21(10), 768-779. doi:10.1017/S1355617715001083   DOI
29 Cockburn, P. H. J. (1998). Concurrent performance of cognitive and motor tasks in neurological rehabilitation. Neuropsychological Rehabilitation, 8(2), 155-170. doi:10.1080/713755565   DOI
30 Cohen, J. (1992). Statistical power analysis. Current Directions in Psychological Science, 1(3), 98-101. doi:10.1111/1467-8721.ep10768783   DOI
31 Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P., ... Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. Journal of Clinical Dpidemiology, 62(10), 1-34. doi:10.1016/j.jclinepi.2009.06.006   DOI
32 Lauenroth, A., Ioannidis, A. E., & Teichmann, B. (2016). Influence of combined physical and cognitive training on cognition: A systematic review. BMC Geriatrics, 16(1), 1-14. doi:10.1186/s12877-016-0315-1   DOI
33 Law, L. L., Barnett, F., Yau, M. K., & Gray, M. A. (2014). Effects of combined cognitive and exercise interventions on cognition in older adults with and without cognitive impairment: A systematic review. Ageing Research Reviews, 15, 61-75. doi:10.1016/j.arr.2014.02.008   DOI
34 Lee, B. K., & Sohn, Y. K. (2016). The effects of statistical artifacts on outcomes in meta-analysis: The comparative analysis of hedges-olkin and hunter-schmidt meta-analytic approaches. Health Communication Research, 15, 47-97.
35 Lee, Y. J., & Jung, M. Y. (2016). A systematic review of the dual-task training for stroke with hemiplegia. Therapeutic Science for Neurorehabilitation, 5(1), 23-32. doi:10.22683/tsnr.2016.5.1.023   DOI
36 Liao, Y., Chen, I., Lin, Y. J., Chen, Y., & Hsu, W. (2019). Effects of virtual reality-based physical and cognitive training on executive function and dual-task gait performance in elderly individuals with mild cognitive impairment: A randomized control trial. Frontiers in Aging Neuroscience, 11, 1-10. doi:10.3389/fnagi.2019.00162   DOI
37 Kortte, K. B., Horner, M. D., & Windham, W. K. (2002). The Trail Making Test, part B: Cognitive flexibility or ability to maintain set? Applied Neuropsychology, 9(2), 106-109. doi:10.1207/S15324826AN0902_5   DOI
38 Linde, K., & Alfermann, D. (2014). Single versus combined cognitive and physical activity effects on fluid cognitive abilities of healthy older adults: A 4-month randomized controlled trial with follow-up. Journal of Aging and Physical Activity, 22(3), 302-313. doi:10.1123/JAPA.2012-0149   DOI
39 Priest, A. W., Salamon, K. B., & Hollman, J. H. (2008). Age-related differences in dual task walking: A cross sectional study. Journal of Neuroengineering and Rehabilitation, 5(1), 1-8. doi:10.1186/1743-0003-5-29   DOI
40 Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64, 135-168. doi:10.1146/annurevpsych-113011-143750   DOI
41 Eggenberger, P., Wolf, M., Schumann, M., & de Bruin, E. D. (2016). Exergame and balance training modulate prefrontal brain activity during walking and enhance executive function in older adults. Frontiers in Aging Neuroscience, 8, 1-16. doi:10.3389/fnagi.2016.00066   DOI
42 Tait, J. L., Duckham, R. L., Milte, C. M., Main, L. C., & Daly, R. M. (2017). Influence of sequential vs. simultaneous dual-task exercise training on cognitive function in older adults. Frontiers in Aging Neuroscience, 9, 1-10. doi:10.3389/fnagi.2017.00368   DOI
43 de Bruin, E. D., van Het Reve, E., & Murer, K. (2013). A randomized controlled pilot study assessing the feasibility of combined motor-cognitive training and its effect on gait characteristics in the elderly. Clinical Rehabilitation, 27(3), 215-225. doi:10.1177/0269215512453352   DOI
44 Doi, T., Makizako, H., Shimada, H., Park, H., Tsutsumimoto, K., Uemura, K., & Suzuki, T. (2013). Brain activation during dual-task walking and executive function among older adults with mild cognitive impairment: A fNIRS study. Aging Clinical and Experimental Research, 25(5), 539-544. doi:10.1007/s40520-013-0119-5   DOI
45 Donoghue, O. A., Horgan, N. F., Savva, G. M., Cronin, H., O'Regan, C., & Kenny, R. A. (2012). Association between timed Up-and-Go and memory, executive function, and processing speed. Journal of the American Geriatrics Society, 60(9), 1681-1686. doi:10.1111/j.1532-5415.2012.04120.x   DOI
46 Eggenberger, P., Schumacher, V., Angst, M., Theill, N., & de Bruin, E. D. (2015). Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up. Clinical Interventions in Aging, 10, 1335-1349. doi:10.2147/CIA.S87732   DOI
47 Egner, T., & Hirsch, J. (2005). The neural correlates and functional integration of cognitive control in a Stroop task. Neuroimage, 24(2), 539-547. doi:10.1016/j.neuroimage.2004.09.007   DOI
48 Amieva, H., Jacqmin-Gadda, H., Orgogozo, J. M., Le Carret, N., Helmer, C., Letenneur, L., ... Dartigues, J. F. (2005). The 9 year cognitive decline before dementia of the Alzheimer type: A prospective population-based study. Brain, 128(5), 1093-1101. doi:10.1093/brain/awh451   DOI
49 Liu, Y. C., Yang, Y. R., Tsai, Y. A., & Wang, R. Y. (2017). Cognitive and motor dual task gait training improve dual task gait performance after stroke - A randomized controlled pilot trial. Scientific Reports, 7(1), 1-8. doi:10.1038/s41598-017-04165-y   DOI
50 McDaniel, M. A., Binder, E. F., Bugg, J. M., Waldum, E. R., Dufault, C., Meyer, A., ... Kudelka, C. (2014). Effects of cognitive training with and without aerobic exercise on cognitively demanding everyday activities. Psychology and Aging, 29(3), 717-730. doi:10.1037/a0037363   DOI
51 Smith, A. M., Spiegler, K. M., Sauce, B., Wass, C. D., Sturzoiu, T., & Matzel, L. D. (2013). Voluntary aerobic exercise increases the cognitive enhancing effects of working memory training. Behavioural Brain Research, 256, 626-635. doi:10.1016/j.bbr.2013.09.012   DOI
52 Cornelis, E., Gorus, E., Van Schelvergem, N., & De Vriendt, P. (2019). The relationship between basic, instrumental, and advanced activities of daily living and executive functioning in geriatric patients with neurocognitive disorders. International Journal of Geriatric Psychiatry, 34(6), 889-899. doi:10.1002/gps.5087   DOI
53 Schoene, D., Valenzuela, T., Toson, B., Delbaere, K., Severino, C., Garcia, J., ... Lord, S. R. (2015). Interactive cognitive-motor step training improves cognitive risk factors of falling in older adults-a randomized controlled trial. PLoS One, 10(12), 1-18. doi:10.1371/journal.pone.0145161   DOI
54 Simes, R. J. (1987). Confronting publication bias: A cohort design for meta-analysis. Statistics in Medicine, 6(1), 11-29. doi:10.1002/sim.4780060104   DOI
55 Sterne, J. A., Egger, M., & Moher, D. (2008). Addressing reporting biases. Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series, 297-333. doi:10.1002/9780470712184.ch10
56 Su, C. Y., Wuang, Y. P., Lin, Y. H., & Su, J. H. (2015). The role of processing speed in post-stroke cognitive dysfunction. Archives of Clinical Neuropsychology, 30(2), 148-160. doi:10.1093/arclin/acu057   DOI
57 Theill, N., Schumacher, V., Adelsberger, R., Martin, M., & Jancke, L. (2013). Effects of simultaneously performed cognitive and physical training in older adults. BMC Neuroscience, 14, 1-14. doi:10.1186/1471-2202-14-103   DOI
58 Nishiguchi, S., Yamada, M., Tanigawa, T., Sekiyama, K., Kawagoe, T., Suzuki, M., ... Aoyama, T. (2015). A 12-week physical and cognitive exercise program can improve cognitive function and neural efficiency in community-dwelling older adults: A randomized controlled trial. Journal of the American Geriatrics Society, 63(7), 1355-1363. doi:10.1111/jgs.13481   DOI
59 Mercier, L., Audet, T., Hebert, R., Rochette, A., & Dubois, M. F. (2001). Impact of motor, cognitive, and perceptual disorders on ability to perform activities of daily living after stroke. Stroke, 32(11), 2602-2608. doi:10.1161/hs1101.098154   DOI
60 Mrakic-Sposta, S., Di Santo, S. G., Franchini, F., Arlati, S., Zangiacomi, A., Greci, L., ... Sacco, M. (2018). Effects of combined physical and cognitive virtual reality-based training on cognitive impairment and oxidative stress in MCI patients: A pilot study. Frontiers in Aging Neuroscience, 10, 1-11. doi:10.3389/fnagi.2018.00282   DOI
61 Ogawa, E. F., You, T., & Leveille, S. G. (2016). Potential benefits of exergaming for cognition and dual-task function in older adults: A systematic review. Journal of Aging and Physical Activity, 24(2), 332-336. doi:10.1123/japa.2014-0267   DOI
62 Sterne, J. A., Sutton, A. J., Ioannidis, J. P., Terrin, N., Jones, D. R., Lau, J., ... Tetzlaff, J. (2011). Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. The British Medical Journal, 2011, 1-8. doi:10.1136/bmj.d4002   DOI
63 Wadley, V. G., Okonkwo, O., Crowe, M., & Ross-Meadows, L. A. (2008). Mild cognitive impairment and everyday function: Evidence of reduced speed in performing instrumental activities of daily living. The American Journal of Geriatric Psychiatry, 16(5), 416-424. doi:10.1097/01.JGP.0000310780.04465.13   DOI
64 Schattin, A., Arner, R., Gennaro, F., & de Bruin, E. D. (2016). Adaptations of prefrontal brain activity, executive functions, and gait in healthy elderly following exergame and balance training: A randomized-controlled study. Frontiers in Aging Neuroscience, 8, 1-13. doi:10.3389/fnagi.2016.00278   DOI
65 Arnett, J. A., & Labovitz, S. S. (1995). Effect of physical layout in performance of the Trail Making Test. Psychological Assessment, 7(2), 220-221. doi:10.1037/1040-3590.7.2.220   DOI
66 Bamidis, P. D., Vivas, A. B., Styliadis, C., Frantzidis, C., Klados, M., Schlee, W., ... Papageorgiou, S. G. (2014). A review of physical and cognitive interventions in aging. Neuroscience & Biobehavioral Reviews, 44, 206-220. doi:10.1016/j.neubiorev.2014.03.019   DOI
67 Legault, C., Jennings, J. M., Katula, J. A., Dagenbach, D., Gaussoin, S. A., Sink, K. M., ... SHARP-P Study Group. (2011). Designing clinical trials for assessing the effects of cognitive training and physical activity interventions on cognitive outcomes: The Seniors Health and Activity Research Program Pilot (SHARP-P) study, a randomized controlled trial. BMC Geriatrics, 11(1), 1-14. doi:10.1186/1471-2318-11-27   DOI
68 Rezola-Pardo, C., Arrieta, H., Gil, S. M., Zarrazquin, I., Yanguas, J. J., Lopez, M. A., ... Rodriguez-Larrad, A. (2019). Comparison between multicomponent and simultaneous dual-task exercise interventions in long-term nursing home residents: The Ageing-ONDUAL-TASK randomized controlled study. Age and Ageing, 48(6), 817-823. doi:10.1093/ageing/afz105   DOI