New Multimodal High-intensity Training Program For Older Adults: Preliminary Data On Safety And Feasibility

Exercise can boost physical and cognitive health in older adults. However, there is a lack of accessible exercise programs that foster adherence among older adults. PURPOSE: To establish the safety and feasibility of APEX, a new exercise program designed to optimize fitness and cognitive gains for older adults, evaluate its acute physiological effects in terms of changes in heart rate, and explore its effects on functional fitness and cognition among healthy older adults. METHODS: APEX utilizes a multimodal progressive high-intensity interval training (HIIT) design, emphasizing cardiovascular fitness and muscle strength in high-intensity (HI) intervals and balance and mobility in recovery intervals. A four-week-long, twice-a-week, APEX training was piloted in healthy older adults (n = 4, 71 ± 5 yrs). Before and after the intervention, participants were tested on several functional fitness measures including aerobic endurance, lower body strength, and balance, and cognitive measures. RESULTS: APEX was found to be safe and feasible, with no documented adverse events and high adherence. The target heart rate for the HI exercises was set to 80% of their measured maximum heart rate (MaxHR). All five HI exercises in APEX were statistically comparable to or greater than the target heart rate of 80% MaxHR in a one-tailed one-sample t-test (p > .05), with mean heart rates of 79%, 86%, 85%, 80%, 84% MaxHR for the different exercises. All intervals also showed a significant difference in heart rates between HI and recovery periods in a linear effects model (p < 0.001). Following the intervention, improvements in functional fitness were observed in aerobic endurance (2-Minute Step Test mean difference: +12.67 ± 8.33 steps), lower body strength (Char Stand Test: +2 ± 1 reps), and balance (Timed Up-and-Go: -1.07 ± 1.27 sec; Right Arm Functional Reach Test: +0.5 ± 1.5 in). The intervention was also associated with positive trends in the cognitive domains of executive function, attention, information processing, and working memory. CONCLUSION: APEX offers a promising alternative to traditional cardiovascular exercise modalities for older adults with additional benefits for functional fitness and cognition. These results encourage further testing of APEX in older adults and different clinical populations. National Institutes of Health (NIDCD R56DC020700).