The Effect of Dual Task Training on Cognitive in Alzheimer's Disease

Alzheimer's disease is a progressive neurodegenerative disorder characterized by impairments in memory, executive function, and daily activities. Conventional exercise programs may improve mobility and physical performance, but their impact on cognition is limited. Dual-task training, which integrates motor and cognitive activities simultaneously, has emerged as a promising strategy to enhance neuroplasticity and functional independence in individuals with cognitive decline.

In this study, participants diagnosed with Alzheimer's disease according to standard clinical criteria will be recruited. After baseline assessments, participants will be randomly allocated to one of two groups:

Experimental Group (Dual-Task Training): Participants will perform exercises combining cognitive tasks (e.g., arithmetic, memory recall, word association) with simultaneous motor tasks (e.g., walking, balance training, functional mobility exercises).

Control Group (Conventional Exercise): Participants will engage in standard physical exercises focusing on strength, flexibility, and balance, without added cognitive tasks.

The intervention will span 8 weeks, with three 45-60 minute sessions per week, conducted under supervision by a physiotherapist.

Outcome Measures

Primary Outcomes: Cognitive performance assessed by the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA).

Secondary Outcomes: Functional mobility (Timed Up and Go test), balance (Berg Balance Scale), and quality of life (QoL-AD questionnaire).

Hypothesis

It is hypothesized that dual-task training will lead to greater improvements in cognitive performance and functional independence compared to conventional exercise programs. This study may provide evidence supporting dual-task rehabilitation as a complementary approach in the management of Alzheimer's disease.

Inclusion criteria

• Age ≥ 60 years
• Diagnosed with mild-stage Alzheimer's disease (According to DSM-5 or NINCDS-ADRDA criteria)
• MoCA score between 10-25 (Indicating sufficient cognitive capacity for dual-task training)
• Ability to walk independently or with minimal assistance
• Adequate hearing and vision to enable communication
• Physical and mental capacity to participate in the dual-task training protocol
• Provision of written informed consent (signed informed consent form)

Exclusion criteria

• Diagnosis of advanced-stage Alzheimer's disease (MoCA < 10)
• Presence of additional neurological disorders affecting the motor system (e.g. Parkinson's disease, stroke, multiple sclerosis)
• Severe hearing or vision impairment (inability to respond to visual or auditory stimuli)
• History of psychiatric disorders (e.g., major depression, schizophrenia)
• Orthopedic or cardiopulmonary conditions that would prevent participation in dual-task training
• Participation in another cognitive or physical rehabilitation program within the last 3 months
• Individuals with unstable cognitive status due to recent medication changes