The Synergic Trial (Synchronizing Exercises, Remedies in Gait and Cognition) was a large RCT done across 5 Canadian cities to identify the best ways to improve cognitive function in those with MCI.
They found that combining physical activity with cognitive training has a synergistic effect that’s not seen with either when done alone. The researchers propose that exercise before cognitive training appears to improve blood flow and stimulate the brain to best receive the training.
What should you advise your patients?
Maximize the effect of cognitive activities by priming your brain with physical activity first
Aim for 40 minutes of physical activity, 3 days a week
Push yourself! You know the exercise is meaningful if you can pull your heart rate 20% above baseline and sweat a little
Finish off with some mentally stimulating activity- for example play a game of chess
The best improvements in memory, word finding and attention are seen with progressive aerobic-resistance exercises, then followed by cognitive training
They also looked at Vitamin D supplementation, but this only increased cognition if there was
an underlying deficiency.
Montero-Odasso M, Zou G, Speechley M, et al. Effects of Exercise Alone or Combined With
Cognitive Training and Vitamin D Supplementation to Improve Cognition in Adults With Mild
Cognitive Impairment: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(7):e2324465.