Multicomponent exercise to improve physical and cognitive performance and well-being in nursing home residents: the single- blind, multicentre, randomised controlled PROCARE trial

<title>Abstract</title> <p> <bold>Background:</bold> Ageing is associated with substantial decreases in both motor and cognitive performance. Although physical activity is known to help tackle these declines, there is a lack of motor-cognitive exercise programs tailored to the needs of multimorbid older adults. This study investigated the effect of a multicomponent motor-cognitive exercise intervention on physical performance and psychosocial well-being in nursing home residents. <bold>Methods:</bold> We performed a multicentre, single blinded, randomised controlled trial assigning residents from 26 nursing homes to an intervention (IG) or waiting list control group (CG). The 16-week intervention comprised strength, endurance, balance, flexibility, and dual-task (DT; combination of walking and cognitive tasks) exercises performed twice a week (45-60 minutes). Primary outcomes were lower extremity functional capacity (short physical performance battery, SPPB), gait performance, DT cognitive performance (counting backwards, naming animals while walking), and psychosocial well-being (SF12 health survey, Satisfaction-With-Life-Scale). Secondary outcomes included handgrip strength, functional reach (FR), activities of daily living (Barthel Index), frailty (frailty index), depressive symptoms (Center for Epidemiologic Studies Depression-Scale, CES-D), cognitive performance (Montreal Cognitive Assessment, MoCA), and fall-related self-efficacy (FES-I). Linear mixed models (intention to treat) were used for analysis. <bold>Results:</bold> A total of n=522 participants (84+-8 years, IG: n=296, CG: n=226) were recruited. The IG demonstrated superior improvements in the SPPB (estimate=-0.685, p=.029), handgrip strength (estimate=1.896, p=.002), frailty (estimate=0.166, p=.024), and global cognition (estimate=-2.685, p&lt;.001). No between-group differences were observed for the remaining outcomes (p&gt;.05). <bold>Conclusion:</bold> Our multicomponent exercise programme maintained or enhanced functional motor and cognitive resources in nursing home residents. Implementing specifically tailored multicomponent exercise interventions is feasible and highly recommended. <bold>Trial registration:</bold> German Clinical Trials Register (DRKS; DRKS.de); registration number DRKS00014957 on 9 ^th October 2018. </p>