Aquatic Cognitive-Motor Exercise for Cognition, Balance, and Functional Mobility in Older Adults

Introduction: Cognitive declines and mobility challenges in older adults often hinder exercise, leading to a sedentary lifestyle. Addressing both cognitive and physical health is crucial for enhancing overall well-being in older adults. The purpose of this study was to assess the feasibility and effectiveness of aquatic cognitive-motor exercise on cognition, balance, and functional mobility in older adults. Methods: This pilot randomized controlled study included 25 participants from two retirement communities who were randomly assigned to a control (n = 12, 81 +/- 8 yr old) or aquatic exercise group (n = 13, 83 +/- 7 yr old). The aquatic exercise group received 45 min of moderate-intensity cognitive-motor exercise three times per week for 8 wk. The control group received one fall prevention education class. Results: The session attendance rate for the aquatic exercise program was 95%. Between-group comparisons showed that 8 wk of aquatic exercise improved various measures of cognition with a medium effect size, as assessed by the Stroop Color and Word Test (triangle 2.8, d = 0.51) and the Trail Making Test part B (triangle -19.2 s, d = -0.59). Gait speeds while walking forward (triangle 0.04 m<middle dot>s(-1), d = 0.43) and counting backward by serial 7s (triangle 0.05 m<middle dot>s(-1), d = 0.43) were improved with a small effect size in the aquatic exercise intervention. This change was recognized as a clinically meaningful improvement in older adults. The aquatic intervention group had a medium to large effect size improvement in speed with the Four Square Step Test (triangle -0.6 s, d = -0.42), Timed Up and Go test (triangle -1.1 s, d = -0.50), and Timed Up and Go cognitive test (triangle -1.0 s, d = -0.56), whereas only negligible to small changes were noted with single-leg balance measures. Conclusions: The aquatic cognitive-motor exercise program is feasible and enhanced cognition and functional mobility in older adults.