Supplementary Material for: Effects of Cognitive Training in Flanker Task on Mobility of Older Adults: A Randomized Controlled Trail

Introduction: Cognitive function is considered to be correlated with the older adults’ mobility. Flanker task, reflecting the conflict resolution, is barely explored as a simple approach to train the elderly’s cognitive function. Hence, the first aim of this study is to explore the effect of cognitive intervention adopting flanker task on mobility. The second aim of this study is to assess the effect of cognitive training by comparing it with physical training to disclose how much dosage of cognitive training can have the equal improvement of mobility with physical training. Methods: 232 older adults (age, mean ± SD: 66.16 ± 7.08, female: 74.3%) were retrained and assigned into three groups (cognitive intervention group, physical exercise intervention group, and control group). The intervention lasted for 22 weeks (cognitive intervention: flanker task, 30 min per session, 3 sessions a week; physical exercise intervention: 30 min muscle and balance training session, twice a week, and 30 min daily walking and housework, 2-4 times a week). Grip strength, 30-s chair-stand test, single leg balance with eye closed, and the timed “Up & Go” (TUG) were used as indicators of mobility. A mixed model analysis of variance (ANOVA), interaction effect, and simple effect were performed in statistical analysis. Results: Both intervention groups improved mobility, and the results were similar behaviorally. However, the exercise intervention group performed better in 30-s chair-stand test (25.14±0.67 vs. 23.71±0.76 with p=0.01) and single leg balance with eye closed (8.15±0.69 vs. 6.14±0.43 with p<0.001). Discussion/ Conclusion: 22-week cognitive intervention (for total 1980 min) could improve the elderly’s mobility to the similar extent of mild to moderate physical exercises (1320 min of functional muscle and balance training and 1980 daily physical activities), which ascertained the far transfer effects from cognition to untrained mobility domain and found a comparable dosage of cognitive and physical exercise training.

引言：认知功能被认为与老年人的活动能力密切相关。侧抑制任务（Flanker Task）作为反映冲突解决能力的经典范式，目前尚少被作为简便易行的老年人认知功能训练手段加以探索。因此，本研究的首要目标为探究采用侧抑制任务的认知干预对老年人活动能力的影响；其次，本研究通过将认知训练与体育锻炼进行对照，评估认知训练的干预效果，以明确达到与体育锻炼同等活动能力改善效果所需的认知训练剂量。
方法：本研究共纳入232名老年人（年龄：均值±标准差=66.16±7.08岁；女性占比74.3%），并将其随机分配至三组：认知干预组、体育锻炼干预组及对照组。干预周期为22周：认知干预组采用侧抑制任务训练，每次30分钟，每周3次；体育锻炼干预组的方案为：每次30分钟的肌肉与平衡训练，每周2次，辅以每周2-4次、每次30分钟的日常步行与家务活动。本研究采用握力、30秒椅子站立测试、单腿闭眼平衡测试以及计时起立行走测试（Timed Up & Go, TUG）作为活动能力的评估指标。统计分析采用混合模型方差分析（ANOVA），并检验交互效应与简单效应。
结果：两组干预组的活动能力均得到改善，行为学结果趋势相似。但体育锻炼干预组在30秒椅子站立测试中表现更优（25.14±0.67 vs. 23.71±0.76，p=0.01），且在单腿闭眼平衡测试中表现更佳（8.15±0.69 vs. 6.14±0.43，p<0.001）。
讨论/结论：为期22周的认知干预（总训练时长共计1980分钟），可将老年人的活动能力提升至与轻度至中度体育锻炼（1320分钟的功能性肌肉与平衡训练，以及1980分钟的日常体力活动）相当的程度。本研究证实了认知训练向未经过训练的活动能力领域的远迁移效应，并明确了可与体育锻炼达到等效改善效果的认知训练剂量。