Aquatic Exercises Combined With Cognitive Tasks for Older Adults

Summary

The aquatic environment has characteristics that favor the adherence of older adults to exercise programs, and studies have shown that programs in this setting are effective in enhancing various aspects of physical fitness as well as cognitive function in this population. Research has explored whether incorporating cognitive tasks into an aquatic exercise program could offer additional benefits, but it remains uncertain whether this approach leads to greater improvements in cognitive function compared to aquatic exercises alone. The present protocol reports the WaterCog Study, which aims to evaluate the effects of an aquatic aerobic exercise program combined with cognitive tasks, compared to a conventional aquatic aerobic exercise program and a control group, on cognitive function and other health-related outcomes in older adults. This trial is a randomized, single-blinded, three-arm, parallel, superiority trial. A total of 98 older adults are randomized into one of three groups: 1) an aquatic aerobic exercise program combined with cognitive tasks, 2) a conventional aquatic aerobic exercise program, and 3) a control group. Participants in both exercise groups complete a 12-week exercise program with two weekly sessions on non-consecutive days. The primary outcome is cognitive function, while secondary outcomes include physical function, cardiovascular, and psychosocial parameters. Outcomes are measured at baseline, post-intervention, and at the 12-week follow-up after the end of the intervention period. The analysis plan will employ an intention-to-treat approach and per-protocol criteria. The conceptual hypothesis of the study is that both training programs will significantly improve the investigated outcomes compared to the control group. Additionally, it is expected that aquatic exercises with cognitive tasks will promote additional benefits in cognitive function, with similar gains in physical function, cardiovascular, and psychosocial parameters compared to conventional aquatic aerobic exercises in post-intervention and follow-up measures.

Conditions

• Aging

Interventions

OTHER

Aquatic aerobic exercise program

The aquatic exercise sessions include the following exercises: butt kick, frontal kick, cross-country skiing, and stationary running. These exercises are commonly used in water aerobics classes and provide controlled osteoarticular impact, being safe for older women (Alberton et al., 2019). Training intensity is prescribed using Borg's 6-20 rating of perceived exertion (RPE) scale. The adopted strategy is based on interval training, which alternates between high-intensity effort and low-intensity active recovery phases. Each block consists of 4 minutes of effort (RPE 13 - 15), with one minute for each exercise (butt kick, frontal kick, cross-country skiing, and stationary running) followed by 1 minute of active recovery (RPE 11), performed with stationary running. To facilitate monitoring, an RPE scale (measuring 0.90 × 1.20 m) is fixed to the outside of the pool, in front of the participants.

OTHER

Cognitive tasks

This group performs the same aerobic training protocol used by the conventional aquatic program group. Additionally, cognitive tasks are performed during the active recovery phases. Cognitive training encompasses different domains of cognition in all sessions, including semantic fluency, processing speed, cognitive flexibility, inhibitory control, memory, attention, and reasoning. The exercises vary in each class, with progression in complexity in each mesocycle.

Sponsors & Collaborators

• Federal University of Pelotas

  lead OTHER

Principal Investigators

• Cristine L Alberton, PhD · Federal University of Pelotas

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

60 Years

Max Age

75 Years

Sex

FEMALE

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2025-09-05

Primary Completion

2027-08-31

Completion

2027-08-31

Countries

• Brazil

Study Locations