The Influence of Exercise on Cognitive Function in Older Hispanic/Latino Adults: Results from the “°Caminemos!” Study

Background and Purpose:Physical activity has been found to be an important safeguard against the aging brain by inhibiting cognitive decline. Yet, Hispanic/Latino elderly are less likely to engage in such activities.  While a number of reasons exist, issues related to cognitive attribution--e.g., the belief that becoming sedentary is an unavoidable consequence of aging--may contribute to the racial/ethnic disparity. It is unknown, however, whether Hispanic/Latino older adults would respond to a low-cost exercise program and whether an attribution retraining intervention would further contribute in promoting exercise levels.  This study examines the prospective effect of an evidenced-based exercise intervention (¡Caminemos!) on cognitive function among older Hispanic/Latino adults. In addition, we examine the effects of an attribution retraining intervention given to a randomly selected sample. 

Methods: We analyzed baseline and follow-up (12- and 24-month) data collected from Hispanics/Latinos ≥60 years participating in an exercise intervention (¡Caminemos!) across 27 senior centers (N = 571). All participants were given 4 weekly 1-hour group-based exercise classes targeting strength training, endurance, balance and flexibility.  In addition, they were randomly assigned to one of two conditions: a) treatment group -- a 1-hour attribution retraining session in which participants were taught that aging does not mean one inevitably becomes sedentary, or b) control group -- no attribution retraining.  The Modified Mini-Mental Exam (3MS) was used to assess cognitive functioning with possible scores in the range of 0 to 100; lower scores indicative of greater cognitive impairment. We used a multilevel mixed-effects linear regression for longitudinal changes in cognitive functioning as a result of the exercise class and the attribution retraining component.  Covariates included age, gender, education, income and number of chronic conditions.

Results: Baseline characteristics for this sample include: mean age of 73 years (SD=6.8); 77% female; 18% with income below $10,000; and 44.6% with less than an 8^th grade education. At baseline, participants with evident cognitive impairment (3MS score <80) were older (75.0 vs. 72.2, p<0.001) and were more likely to have lower education (p<0.001), with no differences by gender or number of chronic conditions. In prospective analyses, participants in both intervention arms displayed higher cognitive functioning scores at the 12- (β₁=1.76, p=0.001) and 24-month (β₂=1.37, p=0.013) follow-up periods when compared to their baseline values. Compared to baseline, gains in cognitive functioning in the first year reached 1.8 for both groups, and 1.4 for the control and 1.9 for the intervention group. However, there was no significant difference in the salutary effects on cognitive function between the treatment versus control conditions (β=0.41, p=0.582), nor differences across groups over time.

Conclusions and Implications: The mere availability of a low-cost evidence-based exercise program was associated with enhanced cognitive function in older Hispanic/Latino adults.  Such a finding suggests that exercise disparities may have more to do with access than how the Hispanic/Latino elderly think about the aging process.  Given the expected growth of the older Hispanic/Latino adult population, exercise programs are essential cost-saving strategies in maintaining cognitive ability and promoting health.