Aquatic Exercises Combined With Cognitive Tasks for Older Adults

NCT07156708 | Recruiting

• 1 other identifier: 90526525.0.0000.5313
• Study Type: interventional
• Target: 98
• Locations: 1 country
• Sites: 1

Brief 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

Keywords

Physical exercise; Physical activity; Dual-task training; Water-based exercise; Cognitive function; Physical fitness; Mental health; Sleep quality; Quality of life; Cardiovascular parameters

Outcome Measures

Primary Outcomes (2)

• Objective cognitive function - Digit Span Test

  The Digit Span Test is used to assess working memory and attention span (Schroeder et al., 2012). The Digit Span Test requires participants to verbally recall a sequence of numbers dictated by the examiner. The test begins with three numbers ranging from 0 to 9, read at 1-second intervals, which participants must remember in the correct order. The sequence increases by one digit if pronounced correctly. If participants fail to recall the correct sequence twice in a row, the test ends. The number of digits correctly recalled is recorded as the test result, with a higher score indicating better performance.

  Baseline (week 0), post-intervention (week 13), and 12-week follow-up (week 25)

• Objective cognitive function - Controlled Oral Word Association Test

  The Controlled Oral Word Association Test (COWAT) is used to assess verbal fluency, working memory, and inhibitory control (Ross et al., 2007). In this test, participants must say as many words as possible that start with the letters "F," "A," and "S" within 1 minute for each letter. Proper names, repeated words, and variations in gender, number, and conjugation are not considered. A higher number of words in each test indicates better verbal fluency.

  Baseline (week 0), post-intervention (week 13), and 12-week follow-up (week 25)

Secondary Outcomes (14)

• Objective cognitive function - Trail Making Test (TMT)

  Baseline (week 0), post-intervention (week 13), and 12-week follow-up (week 25)

• Self-perception of cognitive function

  Baseline (week 0), post-intervention (week 13), and 12-week follow-up (week 25)

• Aerobic fitness

  Baseline (week 0) to post-training (week 13)

• Lower limb strength

  Baseline (week 0) to post-training (week 13)

• Upper limb strength

  Baseline (week 0) to post-training (week 13)

Other Outcomes (11)

• Cognitive status

  Baseline (week 0)

• Sociodemographic and clinical characteristics

  Baseline (week 0)

• Body mass

  Baseline (week 0) to post-training (week 13)

Study Arms (3)

Aquatic aerobic exercise program combined with cognitive tasks

EXPERIMENTAL

Other: Aquatic aerobic exercise program; Other: Cognitive tasks

Conventional aquatic aerobic exercise program

EXPERIMENTAL

Other: Aquatic aerobic exercise program

Control group

NO INTERVENTION

Interventions

Aquatic aerobic exercise program OTHER

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.

Aquatic aerobic exercise program combined with cognitive tasks; Conventional aquatic aerobic exercise program

Cognitive tasks OTHER

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.

Aquatic aerobic exercise program combined with cognitive tasks

Eligibility Criteria

• Age: 60 Years - 75 Years
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Older women aged 60 and 75 years;
• Being physically inactive, meaning not participating in physical exercise for at least six months (regular exercise is defined as engaging in any physical training for a minimum of 20 minutes on two or more days a week).

You may not qualify if:

• History of cardiovascular disease (except controlled hypertension);
• Osteoarticular limitations for the practice of exercises;
• Being illiterate due to the self-completion questionnaires and the characteristics of the intervention;
• Diagnosis of dementia, schizophrenia, or major depressive disorder.

Sponsors & Collaborators

• Federal University of Pelotas: lead

Study Sites (1)

Escola Superior de Educação Física e Fisioterapia

Pelotas, Rio Grande do Sul, 96055-630, Brazil

RECRUITING

Related Publications (13)

• Foster C, Florhaug JA, Franklin J, Gottschall L, Hrovatin LA, Parker S, Doleshal P, Dodge C. A new approach to monitoring exercise training. J Strength Cond Res. 2001 Feb;15(1):109-15.

  PMID: 11708692 BACKGROUND

• Sao-Joao TM, Rodrigues RC, Gallani MC, Miura CT, Domingues Gde B, Godin G. [Cultural adaptation of the Brazilian version of the Godin-Shephard Leisure-Time Physical Activity Questionnaire]. Rev Saude Publica. 2013 Jun;47(3):479-87. doi: 10.1590/s0034-8910.2013047003947. Portuguese.

  PMID: 24346560 BACKGROUND

• Brucki SM, Nitrini R, Caramelli P, Bertolucci PH, Okamoto IH. [Suggestions for utilization of the mini-mental state examination in Brazil]. Arq Neuropsiquiatr. 2003 Sep;61(3B):777-81. doi: 10.1590/s0004-282x2003000500014. Epub 2003 Oct 28. Portuguese.

  PMID: 14595482 BACKGROUND

• Fleck MP, Louzada S, Xavier M, Chachamovich E, Vieira G, Santos L, Pinzon V. [Application of the Portuguese version of the abbreviated instrument of quality life WHOQOL-bref]. Rev Saude Publica. 2000 Apr;34(2):178-83. doi: 10.1590/s0034-89102000000200012. Portuguese.

  PMID: 10881154 BACKGROUND

• Bertolazi AN, Fagondes SC, Hoff LS, Dartora EG, Miozzo IC, de Barba ME, Barreto SS. Validation of the Brazilian Portuguese version of the Pittsburgh Sleep Quality Index. Sleep Med. 2011 Jan;12(1):70-5. doi: 10.1016/j.sleep.2010.04.020. Epub 2010 Dec 9.

  PMID: 21145786 BACKGROUND

• Botega NJ, Bio MR, Zomignani MA, Garcia C Jr, Pereira WA. [Mood disorders among inpatients in ambulatory and validation of the anxiety and depression scale HAD]. Rev Saude Publica. 1995 Oct;29(5):355-63. doi: 10.1590/s0034-89101995000500004. Portuguese.

  PMID: 8731275 BACKGROUND

• Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Eur Heart J. 1996 Mar;17(3):354-81. No abstract available.

  PMID: 8737210 BACKGROUND

• STROOP, J. R. Studies of interference in serial verbal reactions. Journal of Experimental Psychology, v. 18, n. 6, p. 643-662, 1935.

  BACKGROUND

• de Paula JJ, Costa DS, Miranda DM, Romano-Silva MA. Brazilian version of the Cognitive Failures Questionnaire (CFQ): cross-cultural adaptation and evidence of validity and reliability. Braz J Psychiatry. 2018 Jul-Sep;40(3):312-315. doi: 10.1590/1516-4446-2017-2227. Epub 2017 Dec 11.

  PMID: 29236920 BACKGROUND

• Carvalho GA, Caramelli P. Normative data for middle-aged Brazilians in Verbal Fluency (animals and FAS), Trail Making Test (TMT) and Clock Drawing Test (CDT). Dement Neuropsychol. 2020 Jan-Mar;14(1):14-23. doi: 10.1590/1980-57642020dn14-010003.

  PMID: 32206193 BACKGROUND

• Ross TP, Calhoun E, Cox T, Wenner C, Kono W, Pleasant M. The reliability and validity of qualitative scores for the Controlled Oral Word Association Test. Arch Clin Neuropsychol. 2007 May;22(4):475-88. doi: 10.1016/j.acn.2007.01.026. Epub 2007 Feb 20.

  PMID: 17317094 BACKGROUND

• Schroeder RW, Twumasi-Ankrah P, Baade LE, Marshall PS. Reliable Digit Span: a systematic review and cross-validation study. Assessment. 2012 Mar;19(1):21-30. doi: 10.1177/1073191111428764. Epub 2011 Dec 6.

  PMID: 22156721 BACKGROUND

• Alberton CL, Nunes GN, Rau DGDS, Bergamin M, Cavalli AS, Pinto SS. Vertical Ground Reaction Force During a Water-Based Exercise Performed by Elderly Women: Equipment Use Effects. Res Q Exerc Sport. 2019 Dec;90(4):479-486. doi: 10.1080/02701367.2019.1620910. Epub 2019 Jun 11.

  PMID: 31184984 BACKGROUND

MeSH Terms

Conditions

Motor Activity; Psychological Well-Being; Sleep Initiation and Maintenance Disorders

Condition Hierarchy (Ancestors)

Behavior; Personal Satisfaction; Sleep Disorders, Intrinsic; Dyssomnias; Sleep Wake Disorders; Nervous System Diseases; Mental Disorders

Study Officials

• Cristine L Alberton, PhD

  Federal University of Pelotas

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Mariana B Gomes

CONTACT

5553999815166; marianaaaborba@gmail.com

Henrique S Ferreira

CONTACT

5553991211115; henriquex2001@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Blinding is applied to outcome assessors and data analysts responsible for evaluating both primary and secondary outcomes. However, due to the nature of the interventions, blinding is not feasible for the staff conducting the exercise sessions or the participants. To maintain assessor blinding, participants are instructed not to disclose their group allocation or discuss intervention details during outcome assessments.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: This trial is a randomized clinical trial employing a 1:1:1 allocation ratio. It was designed as a superiority trial with three parallel groups and blinded to outcome assessors and data analysis.

Study Record Dates

• First Submitted: August 26, 2025
• First Posted: September 5, 2025
• Study Start: September 5, 2025
• Primary Completion (Estimated): August 1, 2027
• Study Completion (Estimated): August 1, 2027
• Last Updated: September 9, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will share

Locations

BR (1)