Cognitive decline is common among the oldest-old, particularly in assisted living facilities (ALFs). This pilot randomized controlled trial examined the effects of aerobic, resistance, and mind-body exercises on cognition in ALF residents aged ≥80 years, and the feasibility and safety of exercise programs. In a 24-week four-arm trial 76 participants (aged 86.8 ± 4.1; 72.4% female) were randomized to aerobic, resistance, mind-body (simplified Tai Chi), or non-exercise control groups. Thirty-minute exercise sessions were delivered three times weekly for 24 weeks. Cognition was assessed at baseline, Week 12, and Week 24 using the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Immediate Story Recall (ISR), Boston Naming Test (BNT), Trail Making Test-A (TMT-A), and Trail Making Test-B (TMT-B). Data were analyzed using intention-to-treat baseline-adjusted linear mixed-effects models with Holm-adjusted pairwise contrasts.
At week 24, aerobic and mind-body groups showed higher MMSE scores than control (aerobic–control Δ = 3.45, 0.92 to 5.99, pHolm = 0.0481; mind-body–control Δ = 3.29, 0.81 to 5.77, pHolm = 0.0492). Mind-body exercise showed higher ISR scores than control (ISR Δ = 9.84, 3.22 to 16.46, pHolm = 0.0234), whereas aerobic exercise showed better TMT-B performance than control (TMT-B Δ = -25.66 s, −41.95 to −9.37, pHolm = 0.0137). MoCA, BNT, and TMT-A differences were not significant after multiple-comparison correction. These exercise programs were feasible and safe in ALF residents aged ≥80. Aerobic and mind-body exercise improved specific cognitive outcomes.
Please use the link below to access the full published paper for free before 24 June 2026