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/Study Context: Although motor imagery is a well-established phenomenon in healthy younger adults, it seems necessary to determine if older adults are still able to accurately perform imagery tasks before investigating the application of motor imagery in rehabilitation. Therefore, the purpose of this study was to determine if there is a progressive decline in motor imagery performance with age. Furthermore, we wanted to verify whether the effects of age on motor imagery were due to (or mediated by) deficits of working memory. Methods: This study examined the key characteristics of the motor imagery ability in three groups of healthy older men and women (60–69, 70–79, and ≥80 years; mean age M = 73.8, SD = 8.3) and 40 younger subjects aged 20 to 30 years (M = 28.87, SD = 2.5). Imagery ability was measured using the Movement Imagery Questionnaire (MIQ), the Controllability of Motor Imagery (CMI) test, and two different chronometry tests. To estimate the mediational effect of working memory on age differences in the imagery measures, we employed latent variable structural equation modeling (SEM). Results: The main findings indicated that motor imagery ability (generation, visual and kinesthetic imagery ability, controllability, and temporal organization) were better in young adults compared with older adults 70 years and older, but not in older adults 60 to 69 years of age. The analysis of the mediational effect of working memory on age differences in the motor imagery measures showed that the inclusion of working memory increased the amount of explained variance in the MIQ (ΔR ² = .03), in the CMI test (ΔR ² = .15), as well as in the mental chronometry tests (ΔR ² = .16) Conclusion: Our findings suggest that there is potential for motor imagery to be compromised in the older age ranges, which may limit motor imagery as a rehabilitative strategy in older and in cognitively impaired individuals.

Although several studies have shown that dual-tasking (DT) mobility is impaired in Alzheimer's disease, studies on the effects of DT conditions in probable Mild Cognitive Impairment (pMCI) have not yielded unequivocal results. The objectives of the study were to (1) examine the effect of a concurrent task on a complex walking task in adults with cognitive impairment; and (2) determine whether the effect varied with different difficulty levels of the concurrent task. Furthermore, the study was designed to evaluate the Trail-Walking Test (TWT) as a potential detection tool for MCI. We examined DT performance in 42 young adults (mean age 23.9 ± 1.98), and 43 older adults (mean age 68.2 ± 6.42). The MoCA was used to stratify the subjects into those with and without pMCI. DT was assessed using the TWT: participants completed 5 trials each of walking along a fixed pathway, stepping on targets with increasing sequential numbers (i.e., 1-2-…-15), and increasing sequential numbers and letters (i.e., 1-A-2-B-3-…-8). Motor and cognitive DT effects (DTE) were calculated for each task. ROC curves were used to distinguish younger and healthy older adults from older adults with pMCI. The TWT showed excellent test-retest reliability across all conditions and groups (ICC : 0.83–0.97). SEM% was also low (<11%) as was the MDC95% (0.7, p < 0.05). The TWT is a reliable DT mobility measure in people with pMCI. However, the condition with high cognitive load is more sensitive than the condition with low cognitive load in identifying pMCI. The TWT-3 thus could serve as a screening tool for early detection of individuals with pMCI. Future studies need to determine the neural correlates for cognitive-motor interference in older adults with pMCI.

Background: Executive functions (EFs) not only play an important role in shaping adolescent’s goal-directed, future-oriented cognitive skills under relatively abstract, non-affective conditions (Cool EF), but also under motivationally significant, affective conditions (Hot EF). Empirical evidence suggest a link between EF, exercise and physical activity, specifically elite adult athletes appear to outperform amateur athletes in Cool EF; however, no previous studies have examined the relationship between Hot and Cool EFs and impulsivity during the developmentally sensitive period of adolescence comparing different types of sport (open- vs. closed-skills), and levels (elite athletes vs. amateurs). Methods: A total 86 boys and girls between 13 and 15 years of age (mean: 14.0, SD: 0.79) from different sports (track-and-field; team handball) were recruited. Participants were further divided into two groups: (a) 40 elite, and (b) 46 amateur athletes. They completed four Cool EF tasks including Trail-Making Test, Trail-Walking-Test, Flanker task, n-back-task, and one Hot EF task on Game of Dice task. Data on subjective impulsivity (UPPS Impulsive Behavior Scale; Barratt Impulsiveness Scale-15) was also collected. Results: There was a significant overall effect for expertise in favor of elite athletes (Wilks’ Lambda = 0.61, F(14,69) = 3.19, p = 0.001, ${\mathrm{\eta }}_{\text{p}}^2$ = 0.393), but no overall main effect for type of sport or an interaction for expertise by type of sport. Specifically, elite athletes showed significantly better performances on dual tasks. For Hot EF, there were no main effects for type of sport, expertise level, training experience or training duration. We also found positive correlations among Cool EF and impulsivity measures, and between Hot EF and Impulsivity, but no significant relationship between Cool and Hot EF. Conclusion: The current understanding of the decisive cognitive abilities does not correspond to sporting reality, so that the tests frequently used are not sensitive enough to distinguish between elite and amateur athletes or different sports. However, it should also be remembered that the factors underlying complex sporting performance are multidimensional and are obviously difficult to trace back to selected partial aspects. Without being able to answer this question conclusively, we proposed a 4-D classification of experimental paradigms, in which we differentiate between tasks of different specificity, between Cool and Hot EF, and between task complexity, and type of sport.