Synergic trial secondary outcomes results on gait and falls

Abstract Background Older adults with Mild Cognitive Impairment (MCI) have higher risk of gait impairments and falls, yet the effects of multimodal interventions, including combinations of exercises with cognitive training, on improving their mobility remain unclear. Objectives To investigate the synergistic effects of aerobic-resistance exercise combined with cognitive training, with or without vitamin D supplementation, on gait performance and fall risk in older adults with Mild Cognitive Impairment (MCI). Methods The effect of 20 weeks of aerobic-resistance exercise, cognitive training, and vitamin D supplementation (10,000 IU 3x/week) on gait and falls in older adults with MCI was evaluated in the SYNERGIC Trial, using a fractional factorial design. Results Among 161 participants, exercise-based arms (n = 4) improved gait speed (+7.5 cm/s, p < 0.001) and reduced injurious falls by 62% (IRR=0.38, p = 0.04). Exercise plus cognitive training showed the greatest gains in gait speed and reduced injurious falls (IRR=0.13, p = 0.05). Vitamin D did not enhance outcomes and increased gait instability. Conclusion Aerobic-resistance exercise combined with cognitive training improves gait performance and decreases the risk of injurious falls in older adults with MCI. The addition of vitamin D did not produce benefits.