Comparing the Effectiveness of Group Movement and Mindfulness Intervention on the Balance and Executive Functions of the Elderly with Mild Cognitive Impairment

The changes in physical and cognitive functions in old age often lead to impaired motor function and cognitive decline. The changes occur even in the absence of obvious diseases. The potential consequences are increased risk of falling, loss of independence in daily activities, and lower quality of life. Aging is associated with decreased cognitive functions such as processing speed, memory, and executive functions. Group movement intervention in a sports program improves mobility and balance, mental health, cardiovascular health, and strength. It encourages social and emotional participation and saves healthcare costs. Mindfulness is another effective approach to enhance cognition. It includes mindfulness, breathing, and yoga exercises. The present study evaluated and compared the effectiveness of group movement and mindfulness intervention programs on the balance status and executive functioning of older people with mild cognitive impairment.

The present research was quasi–experimental with a pretest–posttest and a one–month follow–up design, with two experimental and one control group(s). The study's statistical population comprised all elderly people aged 60–75 years living in Tehran City, Iran. The investigation started from March 2021 to March 2022. By reviewing similar research studies and using G*Power software, the number of samples required to reach the study objectives was estimated at 60. The samples were eligible elderly male volunteers with mild cognitive disorders. The sampling method was accessible and targeted. The samples were assigned to the group movement intervention (20 people), the mindfulness intervention group (20 people), and the control group (20 people). The inclusion criteria included the consent of the participants to participate in the research; male gender; diagnosis of mild cognitive impairment; 60–75 years old; without acute mental disorders, critical physical illness, or movement problems that prevent their activities. The exclusion criteria included not participating regularly in training sessions, suffering from disease or any injury that prevents doing exercises, participating in other activities that affect the training interventions, and unwillingness to continue the research for any reason. The following tools were used for data collection: Mini–Mental State Examination (MMSE) (Folstein et al., 1977), Fullerton Advanced Balance (FAB) Scale (Rose et al., 2006), and Delis–Kaplan Executive Function System (D–KEFS) (Delis et al., 2001). Group movement and mindfulness interventions were implemented only for the experimental groups, each for 12 sixty–minute sessions. Descriptive statistics (mean and standard deviation) and inferential statistics (Repeated measures ANOVA and its assumptions and Bonferroni's post hoc test) were used to analyze the data. All statistical tests were analyzed at a significance level of 0.05. SPSS version 24 software was used for data analysis.

Results showed that the effects of time (p<0.001), group (p<0.001), and the time and group interaction (p<0.001) on the variables of balance status and executive functions were significant. In the posttest and follow–up phases, the average scores of the variables of balance status and executive functions in the group movement intervention (p<0.001) and the mindfulness intervention (p<0.001) were significantly higher than those in the control group. However, a significant difference was observed between the experimental groups in the posttest and follow–up phases (p<0.001). In the two experimental groups, there was a significant difference in the average scores of variables of balance status and executive functions between the pretest and posttest (p<0.001) and between the pretest and follow–up (p<0.001) stages. Also, a significant difference was observed in the mean scores of the mentioned variables between the posttest and follow–up stages (p<0.001), which shows the stability of the interventions in the follow–up stage.

According to the findings, group movement and mindfulness interventions benefit executive functions and balance status. However, group movement intervention is more effective than mindfulness training. Therefore, therapists can use the group movement intervention to improve the balance and executive functions of older people with mild cognitive impairment.