Effects of cognitive-motor dual-task walking exercise versus walking-only exercise on cognitive function and patient-centred outcomes in older adults with subjective brain fog: a randomised controlled trial
Year: 2026
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Objective To compare the effects of cognitive-motor dual-task walking exercise and walking-only exercise on cognitive function and patient-centred outcomes in older adults with subjective brain fog. Design Assessor-blinded, parallel-group randomised controlled trial. Setting Outpatient clinics at a single university hospital in Istanbul, Türkiye. Participants 90 community-dwelling adults aged 65 years or older with subjective brain fog symptoms were randomly allocated to the exercise-only (EX; n=45) or cognitive-motor exercise (CM-EX; n=45) group. All participants completed the 4-week follow-up. Interventions Both groups received supervised walking exercise three times weekly for 4 weeks. The CM-EX group performed cognitive tasks concurrently with walking. Primary and secondary outcome measures The primary outcome was global cognitive function measured using the Montreal Cognitive Assessment (MoCA). Secondary outcomes were brain fog severity, depressive symptoms, sleep quality and quality of life, assessed using the Brain Fog Scale, Geriatric Depression Scale, Pittsburgh Sleep Quality Index and WHO Quality of Life Instrument-Older Adults Module (WHOQOL-OLD), respectively. Results Both groups showed within-group improvements in MoCA scores (both p<0.001). The prespecified analysis of covariance (ANCOVA) estimated a baseline-adjusted between-group difference of −0.31 points (CM-EX minus EX 95% CI −1.38 to 0.76; p=0.566; partial eta squared (η²p)=0.004). An exploratory group-by-baseline MoCA interaction was observed (p=0.011), warranting cautious interpretation of the average adjusted difference. Brain fog severity decreased in both groups, with an exploratory baseline-adjusted between-group difference favouring EX (p=0.029; η²p=0.054). This finding should be interpreted cautiously because baseline scores differed between groups and no adjustment for multiple comparisons was applied. Depressive symptoms improved in both groups, with no significant between-group difference (p=0.069; η²p=0.038). Global sleep quality improved within EX (p=0.015) but not CM-EX (p=0.202); the between-group difference was not significant. WHOQOL-OLD total scores improved within EX (p=0.009), but not CM-EX (p=0.118), with no significant adjusted between-group difference (p=0.340; η²p=0.010). Conclusions Cognitive-motor dual-task walking did not show superiority over walking-only exercise for global cognitive function or most secondary outcomes after 4 weeks. The exploratory MoCA interaction and short intervention period warrant cautious interpretation. Trial registration number NCT07396779.
Source: BMJ Open
Authors: Emre Dansuk, Burak Menek
Institutions: Istanbul Medipol University, Bursa Uludağ Üni̇versi̇tesi̇
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,839
OpenAlex ID: W7223042320