The Impact of Physical Exercise on Working Memory in Elderly People With Mild Cognitive Impairment

Overview

Age-related cognitive decline has evolved into a global public health concern, with deteriorated executive function serving as its predominant manifestation. Working memory, a vital component of executive function, refers to a capacity-limited system that temporarily stores and manipulates information during sophisticated cognitive processes such as language comprehension, learning, and reasoning. It constitutes the core of general cognitive functioning and underpins daily functional performance. The prefrontal cortex is a pivotal brain region subserving working memory and is highly vulnerable to pathological aging. Advancing age triggers prefrontal cortical atrophy and reduced synaptic density, which in turn induces working memory impairment. Consistently, existing evidence identifies working memory as one of the cognitive domains most susceptible to aging and among the first functions compromised in neurodegenerative disorders including Alzheimer's disease. As a non-pharmacological strategy, physical exercise intervention has been validated to exert favorable effects on cognitive improvement. Both aerobic and resistance training effectively ameliorate working memory; nevertheless, head-to-head evidence comparing their intervention efficacy among older adults with mild cognitive impairment (MCI) remains scarce, particularly regarding underlying neurophysiological mechanisms. This study aims to explore the impacts of physical training on working memory in older women living with MCI. Accordingly, the present study aimed to investigate the effects of both a single exercise session and a 12-week intervention on upper- and lower-limb muscle strength and working memory in older women with MCI. In addition, we sought to examine the statistical associations between changes in muscle strength and working memory, with particular attention to the potential mediating role of muscle strength changes. Previous studies have suggested that interventions targeting muscle strength and physical function in middle-aged and older adults are commonly implemented over 12-52 weeks at a frequency of two to three sessions per week, whereas exercise interventions targeting cognitive function in older adults are often conducted over 12-24 weeks at a similar frequency. Based on this evidence, together with feasibility considerations in residential care settings, we adopted a 12-week intervention delivered three times per week. This study contributes to the literature by integrating both acute and chronic effects within a single randomized controlled framework and by exploring the muscle strength-cognition pathway as a potential explanatory mechanism for exercise-related cognitive benefits.

Interventions

• Behavioral Resistance band exercise intervention
  Perform resistance training using Thera-Band resistance bands. Warm up for 5 minutes; proceed to the main workout, which consists of 10 exercises. Perform 2 sets of each exercise, with 8 to 12 repetitions per set, resting for 1 minute between sets. The session lasts approximately 25 to 30 minutes; finish with a cool-down and stretching.
• Behavioral Brisk walking intervention
  Warm up for 5 minutes, then walk briskly for 25 to 30 minutes once you reach your target heart rate for moderate intensity (65%-75% of HRmax); finish with a cool-down.
• Behavioral Eight-Section brocade exercise intervention
  A 5-minute warm-up and stretching session; followed by two sets of the 'Eight Brocades' fitness qigong routine compiled by the General Administration of Sport, lasting approximately 24 minutes in total; and finally, a cool-down and relaxation session.
• Behavioral Control
  Maintain current routine.

Primary outcome measures

• The N-back working memory task [Time frame: This study runs from 4 March 2026 to 31 August 2026. Each participant receives assessments within one week at baseline and one week after intervention.]

Secondary outcome measures (1)

• Montreal Cognitive Assessment Scale [Time frame: This study runs from 4 March 2026 to 31 August 2026. Each participant receives assessments within one week at baseline and one week after intervention.]

Eligibility criteria

Inclusion criteria

• Age >= 65years;
• Free from major organic diseases or cardiovascular diseases, and showing no contraindications to exercise according to the pre-exercise screening questionnaire developed by the American Heart Association (AHA) and the American College of Sports Medicine (ACSM);
• Able to communicate effectively and, subject to their condition, cooperate in completing questionnaires and tests;
• Willing to participate in this study and sign an informed consent form.

Exclusion criteria

• Suffering from severe cognitive impairment, mental illness or other neurodegenerative diseases (such as Parkinson's dementia, stroke, frontotemporal degeneration, vascular dementia, Lewy body dementia, etc.), where the condition impairs communication or the ability to follow experimental instructions;
• Suffering from severe physical injuries that prevent prolonged standing, standing or participation in physical activities;
• Currently taking, or having taken in the recent past, psychotropic drugs or medications that affect physical mobility;
• Plans for surgical treatment in the near future (within the next 6 months);
• Unwillingness to participate in or withdrawal from this study.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Supportive care

Study locations

China · 1 center

• Shanghai University of Sport — Shanghai

Identifiers

NCT: NCT07644156 · 102772025RT275 · 22BTY076 · 11DZ2261100 · 102772025RT275

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗