This systematic review investigated whether healthy older adults benefit from training interventions in motor–cognitive dual-task (DT) situations and which specific aspects of the intervention and/or task selection contribute to training benefits. Training effects were analysed with regard to the training programme (e.g., general ST or DT training) and task conditions (e.g., standing or walking, complexity of secondary cognitive task). Literature was searched via OVIDsp (Medline, EMBASE, PsycINFO). DT studies were included by the following criteria: (1) investigation of at least one motor task, (2) assessment of DT performance outcomes on standing or walking, (3) conduction of an intervention, and (4) investigation of older adults in an experimental–control group design or an old–young comparison. Thirteen studies met all inclusion criteria. Four types of interventions were identified: (1) general single-task (ST) motor training, (2) specific ST motor training, (3) general DT training, and (4) task-related (specific) DT training. For DT standing conditions only DT interventions improved motor performance, whereas DT walking also benefits by ST training. Most benefits on motor and cognitive performance seem to be reached by DT training interventions whereas a GST produced lowest effects. Thus, balance orientated motor and cognitive DT performance in healthy older adults can be improved by performance related exercises. Furthermore, to reach beneficial effects, it seems necessary that the training intervention includes a certain level of exercise load such as rising difficulties, appropriate intensity and duration, a certain level of task specificity, and variable task prioritization. The transfer of training effects into everyday situations needs to be further investigated.

Background: Ageing is associated with physical and cognitive decline, affecting independence and quality of life in older people. Recent studies show that in particular executive functions are important for daily-life function and mobility. This systematic review investigated the effectiveness of cognitive-motor training including exergaming on executive function (EF, set-shifting, working memory, inhibitory control) in healthy older people. Methods: An electronic database search for randomised controlled trials (RCT), controlled clinical trials (CCT) and parallel group trials was performed using MEDLINE, EMBASE, and PsychINFO following PRISMA guidelines. Inclusion criteria were: (1) community-dwelling participants > 60 years without a medical condition or medical treatment, (2) reporting at least one cognitive-motor intervention while standing or walking, (3) use of dual-task interventions using traditional methods or modern technology to deliver a cognitive-motor task, (4) inclusion of at least one cognitive outcome. The PEDro scale was used for quality assessment. Results: A total of 1557 studies were retrieved, of which 25 studies were included in this review. Eleven studies used a technology-based dual-task intervention, while 14 trials conducted a general cognitive-motor training. The age range of the cohort was 69 to 87 years. The interventions demonstrated positive effects on global cognitive function [mean difference 0.6, 95% CI 0.29–0.90] and inhibitory control [mean difference 0.61, 95% CI 0.28–0.94]. Effects were heterogeneous (I² range: 60–95) and did not remain after a sensitivity analysis. Processing speed and dual-task costs also improved, but meta-analysis was not possible. Conclusion: Cognitive-motor and technology-based interventions had a positive impact on some cognitive functions. Dual-task interventions led to improvements of domains related global cognitive functions and inhibitory control. Likewise, technology-based exergame interventions improved functions related to processing speed, attentional and inhibitory control. Training interventions with a certain level of exercise load such as progression in difficulty and task specificity were more effective to gain task-related adaptations on cognitive functions.

Background: Older adults, who are living in nursing homes that provide a high level of long-term nursing care, are characterized by multimorbidity and a high prevalence of dependency in activities of daily living. Results of recent studies indicate positive effects of structured exercise programs during long-term care for physical functioning, cognition, and psychosocial well-being. However, for frail elderly the evidence remains inconsistent. There are no evidence-based guidelines for exercises for nursing home residents that consider their individual deficits and capacities. Therefore, high-quality studies are required to examine the efficacy of exercise interventions for this multimorbid target group. The purpose of this study is to determine the feasibility and efficacy of a multicomponent exercise intervention for nursing home residents that aims to improve physical and cognitive functioning as well as quality of life. Methods: A two-arm single-blinded multicenter randomized controlled trial will be conducted, including 48 nursing homes in eight regions of Germany with an estimated sample size of 1120 individuals. Participants will be randomly assigned to either a training or a waiting time control group. For a period of 16 weeks the training group will meet twice a week for group-based sessions (45–60 min each), which will contain exercises to improve physical functioning (strength, endurance, balance, flexibility) and cognitive-motor skills (dual-task). The intervention is organized as a progressive challenge which is successively adapted to the residents’ capacities. Physical functioning, cognitive performance, and quality of life will be assessed in both study groups at baseline (pre-test), after 16-weeks (post-treatment), and after 32-weeks (retention test, intervention group only). Discussion: This study will provide information about the efficacy of a multicomponent exercise program in nursing homes (performance, recruitment). Results from this trial will contribute to the evidence of multicomponent exercises, which specifically focus on cognitive-motor approaches in the maintenance of mental and physical functioning. In addition, it will help to encourage older adults to actively engage in social life. Furthermore, the findings will lead to recommendations for health promotion interventions for frail nursing home residents. Trial registration: The trial was prospectively registered at DRKS.de with the registration number DRKS00014957 on October 9, 2018.

Background: Children and adolescents increasingly do not meet physical activity (PA) recommendations. Hence, insufficient PA (IPA) and sedentary behavior (SB) among children and adolescents are relevant behavior change domains for using individualized mobile health (mHealth) interventions. Objective: This review and meta-analysis investigated the effectiveness of mHealth interventions on IPA and SB, with a special focus on the age and level of individualization. Methods: PubMed, Scopus, Web of Science, SPORTDiscus, and Cochrane Library were searched for randomized controlled trials published between January 2000 and March 2021. mHealth interventions for primary prevention in children and adolescents addressing behavior change related to IPA and SB were included. Included studies were compared for content characteristics and methodological quality and summarized narratively. In addition, a meta-analysis with a subsequent exploratory meta-regression examining the moderating effects of age and individualization on overall effectiveness was performed. Results: On the basis of the inclusion criteria, 1.3% (11/828) of the preliminary identified studies were included in the qualitative synthesis, and 1.2% (10/828) were included in the meta-analysis. Trials included a total of 1515 participants (mean age (11.69, SD 0.788 years; 65% male and 35% female) self-reported (3/11, 27%) or device-measured (8/11, 73%) health data on the duration of SB and IPA for an average of 9.3 (SD 5.6) weeks. Studies with high levels of individualization significantly decreased insufficient PA levels (Cohen d=0.33; 95% CI 0.08-0.58; Z=2.55; P=.01), whereas those with low levels of individualization (Cohen d=−0.06; 95% CI −0.32 to 0.20; Z=0.48; P=.63) or targeting SB (Cohen d=−0.11; 95% CI −0.01 to 0.23; Z=1.73; P=.08) indicated no overall significant effect. The heterogeneity of the studies was moderate to low, and significant subgroup differences were found between trials with high and low levels of individualization (χ21=4.0; P=.04; I2=75.2%). Age as a moderator variable showed a small effect; however, the results were not significant, which might have been because of being underpowered. Conclusions: Evidence suggests that mHealth interventions for children and adolescents can foster moderate reductions in IPA but not SB. Moreover, individualized mHealth interventions to reduce IPA seem to be more effective for adolescents than for children. Although, to date, only a few mHealth studies have addressed inactive and sedentary young people, and their quality of evidence is moderate, these findings indicate the relevance of individualization on the one hand and the difficulties in reducing SB using mHealth interventions on the other. Trial Registration: PROSPERO CRD42020209417; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209417

Walking in natural environments can be considered a dual-task (DT) scenario that requires increasing cognitive resources with advancing age. Previous reviews concluded that gait speed under DT conditions is equivalent to gait speed as a single task (ST) in the prediction of future falls in older people. However, without a clear taxonomy, these conclusions might be premature. The aim of this review is to use a taxonomy for classifying cognitive tasks of cognitive-motor interference (CMI) paradigms while walking to identify which task domains lead to more pronounced cognitive-motor decrements due to fall risk and concern about falling (CoF) in older people. A systematic literature research following PRISMA guidelines was conducted using MEDLINE, Psych-Info and EMBASE. Inclusion criteria were: older people ≥60 years with a previous fall or CoF, use of a DT paradigm to discriminate fallers and non-fallers, straight overground walking, reported gait measurements during ST and DT conditions. A meta-analysis estimated the effect of DT costs for the cognitive task domain and spatiotemporal gait parameters. N = 3737 studies were found within the databases. Nineteen studies were included (n = 14 for meta-analysis). Fallers and people with CoF showed reduced walking speed for ST and DT conditions. Effects of DT were examined for mental tracking tasks. The combined odds ratio (OR [95% confidence interval]) for fallers vs. non-fallers for ST was 3.13 [0.47, 5.80] with moderate heterogeneity (I 2 = 48%). For DT, the OR was 5.17 [2.42, 7.93] with low heterogeneity (I 2 = 37%). Comparing participants with and without CoF, the OR for ST was 12.41 [9.97, 14.84] with high heterogeneity (I 2 = 85%) and OR for mental tracking DT was 10.49 [7.58, 13.40] with moderate heterogeneity (I 2 = 51%). CMI was not significantly different between fallers and non-fallers or people with and without CoF; however, our taxonomy revealed a large variety of cognitive conditions and a higher number of studies using mental tracking tasks, which make it impossible to draw firm conclusions. Future studies should use a more standardised and ecologically valid approach when evaluating the validity of DT gait performance in the prediction of falls, CoF or other age-related conditions. This review was registered at Prospero with the ID: CRD42017068912.