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。作为反映冲突解决能力的经典范式，侧抑制任务（Flanker Task）作为一种简便的老年人认知功能训练手段，目前鲜有相关探索。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，通过将认知训练与体育锻炼干预进行对照，评估认知训练的干预效果，以明确达到与体育锻炼相当的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，女性占比74.3%），经训练后随机分为三组：认知干预组、体育锻炼干预组及对照组。干预周期共计22周，其中认知干预组采用侧抑制任务训练，每次30分钟，每周3次；体育锻炼干预组的训练方案为：每次30分钟的肌肉与平衡训练，每周2次，辅以每日30分钟的步行与家务活动，每周2-4次。本研究采用握力、30秒坐站试验、闭眼单腿站立试验以及计时起身行走试验（Timed Up & Go, TUG）作为活动能力的评估指标。统计分析采用混合方差分析（ANOVA），并对交互效应与简单效应进行检验。

结果：两组干预组的活动能力均得到显著改善，行为学结果整体趋于一致。但体育锻炼干预组在30秒坐站试验（25.14±0.67 vs. 23.71±0.76，p=0.01）与闭眼单腿站立试验（8.15±0.69 vs. 6.14±0.43，p<0.001）中表现更优。

讨论与结论：为期22周的认知干预（总训练时长1980分钟）可将老年人的活动能力提升至与轻中度体育锻炼（1320分钟的功能性肌肉与平衡训练，以及1980分钟的日常身体活动）相当的水平，这一结果证实了认知功能向未经过训练的活动能力领域的远迁移效应，并明确了与体育锻炼训练剂量相当的认知训练剂量。