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  • The Review Course in Family Medicine

Improving Cognitive Function: Patients with Mild Cognitive Impairment (MCI)

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?

  1. Maximize the effect of cognitive activities by priming your brain with physical activity first

  2. Aim for 40 minutes of physical activity, 3 days a week

  3. Push yourself! You know the exercise is meaningful if you can pull your heart rate 20% above baseline and sweat a little

  4. Finish off with some mentally stimulating activity- for example play a game of chess

  5. 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.



Reference:

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.

doi:10.1001/jamanetworkopen.2023.24465

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