Effect of a 24‐week resistance exercise intervention on cognitive function in cognitively normal older adults: The AGUEDA randomized controlled trial

INTRODUCTION: The Active Gains in Brain Using Exercise During Aging (AGUEDA) trial examined the effects of a 24 week resistance exercise (RE) intervention on executive function (EF) and other cognitive domains in cognitively normal older adults. METHODS: Ninety participants (mean age, 71.8 years; 57.8% female) were randomized to an RE or control group. At baseline and 24 weeks, EF and other cognitive domains were assessed. RESULTS: The RE group showed significant improvements in overall EF (standardized mean difference [SMD] = 0.39, 95% confidence interval = 0.14, 0.65), with no significant between-group difference (SMD = 0.13, p = 0.37). The RE group showed a significant improvement in attentional/inhibitory control (SMD = 0.43, p < 0.001) compared to the control group, while no effects were observed in other domains (all p > 0.12). Moderation by age, education, and subjective cognitive decline was observed. DISCUSSION: Although no overall EF benefit was observed, RE improved attentional/inhibitory control in cognitively normal older adults. RE may yield greater benefits in vulnerable subgroups. CLINICAL TRIAL REGISTRATION: The trial was registered on ClinicalTrials.gov (ClinicalTrials.gov Identifier: NCT05186090). HIGHLIGHTS: Cognitive effects of resistance exercise (RE) may vary across different cognitive domains in cognitively healthy older adults. Twenty-four week RE produced selective improvements in attention/inhibitory control. RE did not improve executive function (EF), or other cognitive domains (episodic memory, processing speed, visuospatial processing, and working memory). RE improved muscular strength, which were associated with gains in EF, episodic memory and working memory. There is value in personalized exercise interventions tailored to individual risk populations, such as those with higher subjective cognitive decline.