Enhancing Global Cognition and Executive Functions Through Water-Based Exercise in Mild Cognitive Impairment: A Randomized Controlled Trial

Mild cognitive impairment (MCI) is a slight cognitive decline with the ability to perform normal activities in daily life and an increased risk of dementia. Land-based exercise enhances cognitive abilities, but combining cognitive and physical interventions offers greater benefits in MCI. Water-based exercise is a low-impact activity that minimizes joint strain and reduces injury risk. This study investigated the effects of water-based exercise with or without cognitive training on cognition in older adults with MCI. Thirty-seven participants aged 65 years or older with MCI were randomly assigned to two groups: water-based exercise (W; n = 18) and water-based exercise combined with cognitive training (W-COG; n = 19). Both groups performed 60 min water-based aerobic sessions 3 days per week for 12 weeks. Cognitive assessments were conducted at baseline and after 12 weeks. Post-intervention, 77.77% of the W group and 89% of the W-COG group had improved their cognitive ability. Both groups showed significant improvements in their global cognition (<i>p</i> < 0.001, <i>p</i> < 0.001) and visuospatial ability (<i>p</i> < 0.01 for W, <i>p</i> < 0.05 for W-COG), respectively. In addition, cognitive flexibility and shifting abilities improved only in the W-COG group (<i>p</i> < 0.05). These findings suggest that water-based exercise combined with cognitive training enhances cognitive functions more effectively than exercise alone in older adults with MCI.