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Randomized Controlled Trial
. 2025 Aug 29;54(9):afaf242.
doi: 10.1093/ageing/afaf242.

Synergistic effects of exercise, cognitive training and vitamin D on gait performance and falls in mild cognitive impairment-secondary outcomes from the SYNERGIC trial

Frederico Pieruccini-Faria  1   2 , Surim Son  2   3 , Guangyong Zou  3   4 , Quincy J Almeida  5 , Laura E Middleton  6   7 , Nick W Bray  2   8 , Maxime Lussier  9   10 , J Kevin Shoemaker  11 , Mark Speechley  12 , Teresa Liu-Ambrose  13   14   15 , Amer M Burhan  16   17 , Richard Camicioli  18 , Karen Z H Li  19 , Sarah Fraser  20 , Nicolas Berryman  21   22   23 , Louis Bherer  23   24   25 , Manuel Montero-Odasso  1   2   3
Affiliations
Randomized Controlled Trial

Synergistic effects of exercise, cognitive training and vitamin D on gait performance and falls in mild cognitive impairment-secondary outcomes from the SYNERGIC trial

Frederico Pieruccini-Faria et al. Age Ageing. .

Abstract

Background: Older adults with mild cognitive impairment (MCI) have a higher risk of gait impairments and falls; yet, the effects of multimodal interventions, including combinations of exercises with cognitive training, on improving their mobility remain unclear VSports手机版. .

Objectives: To investigate the synergistic effects of aerobic-resistance exercise combined with cognitive training, with or without vitamin D supplementation, on gait performance and falls risk in older adults with MCI V体育安卓版. .

Methods: The effect of 20 weeks of aerobic-resistance exercise, cognitive training, and Vitamin D supplementation (10 000 IU 3×/week) on gait and falls in older adults with MCI was evaluated in the SYNERGIC trial, using a fractional factorial design V体育ios版. Assessments were conducted at baseline, 6-month endpoint (after intervention) and 12-month endpoint (follow-up). Eligible participants were between the ages of 65 and 84 years with MCI enrolled from 19 September 2016 to 7 April 2020. Main outcomes of interest for gait performance were gait speed and gait variability changes, whilst for falls were incidental falls and incidental injurious falls. .

Results: Amongst 161 participants, the four exercise-based arms improved gait speed (+7. 5 cm/s, P < . 001) and reduced falls (incidence rate ratios (IRR) = 0. 65, 95% confidence interval (CI): 0. 32-1. 42, P = . 25) and injurious falls (IRR = 0. 38, 95% CI: 0. 15-1. 05, P = . 05) at 6-month endpoint. Falls reduction reached statistical significance (IRR = 0. 28, 95% CI: 0. 13-0 VSports最新版本. 64, P = . 002) at 12-month endpoint. Exercises combined with cognitive training showed the greatest gains in gait speed at 6-month endpoint (P < . 001) and in reducing falls at 12-month endpoint (IRR = 0. 24, 95% CI: 0. 05-0. 77, P = . 02) compared to the control. Vitamin D did not enhance outcomes and increased gait variability, a marker of instability. .

Conclusion: Aerobic-resistance exercise combined with sequential computerised cognitive training improved gait performance at 6 months and decreased the risk of falls and injuries at 12 months in older adults with MCI. The addition of vitamin D did not produce benefits V体育平台登录. .

Keywords: Falls; Mild Cognitive Impairment; cognitive; exercises; gait; older people; training; vitamin D. VSports注册入口.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
SYNERGIC Trial Consortium flowchart and sample eligible for gait and falls analyses (secondary outcomes).
Figure 2
Figure 2
Intervention effects for gait speed, habitual (a) and fast conditions (b). Bar plots show the gait speed mean change across arms with post-hoc results comparing each arm with control. Right panels (line graphs) show comparisons between pooled arms with control (arm 5) showing their respective slopes of change and standard errors (SEs).
Figure 3
Figure 3
(a) Bar plots show mean change in Gait variability—stride length—across arms; (b) Comparison between pooled arms 1 + 2 + 3 (mixed interventions), arm 4 (exercises) and arm 5 (control) based on post-hoc results and their respective slopes of change and SEs. (c) Effect of adding Vitamin D to exercises on stride length variability compared with exercises with placebo vitamin D and their respective slopes of change and SEs.
See this image and copyright information in PMC

References

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