Effects of Prior Exercise Habits and Adherence on Cognitive Function, Physical Fitness, and Vascular Health in Older Adults: An Exploratory Exercise-Based Intervention Trial

Background and Purpose: Given the irreversible nature of dementia, this study examined the effects of a 20-week exercise-based dementia prevention program in community-dwelling older adults, focusing on prior exercise experience and program adherence. Methods: In this exploratory, non-randomized trial, 55 older adults (65-79 years) were allocated to an intervention (n=26) or control (n=29) group, and blinding was not feasible. The intervention comprised supervised rhythmic aerobic exercise with cognitive-motor components performed three times per week. Cognition was the primary outcome, and secondary outcomes included physical fitness, blood pressure, and blood biomarkers. Subgroup analyses classified participants by prior exercise experience and intervention exposure: G1 and G2 comprised control subgroups with no intervention exposure, whereas G3 and G4 comprised intervention-exposed subgroups stratified by adherence. Results: =0.024) despite declines in physical fitness, whereas higher adherence in G3-G4 was associated with stable or favorable physical performance, with G4 showing a positive trend in the 30-second sit-to-stand test. Systolic blood pressure decreased significantly in G2-G4. Conclusions: Although overall cognitive gains were modest and not group specific, prior exercise experience and sustained adherence were associated with favorable changes in physical fitness and vascular outcomes, suggesting that tailored multicomponent exercise programs and long-term engagement may help promote cognitive health in older adults.