The Effect of Combined Physical Activity and Cognitive Training on Quality of Life in Older Adults
DOI:
https://doi.org/10.48047/3gwp2j52Keywords:
Physical Activity, Cognitive Training, Quality of Life, Older AdultAbstract
Background: Quality of life (QoL) is an individual’s perception of their position in life within the context of their culture, values, goals, expectations, and concerns.
Aim: This study aimed to evaluate the effect of combined physical activity and cognitive training on quality of life in older adults.
Design: A quasi-experimental design was utilized.
Setting: The study was conducted in Shobera El Nakhla, a randomly selected rural area in Sharkia Governorate, Egypt.
Sample: The sample consisted of 100 older adults, and a multistage random sampling technique was employed.
Tools: Data were collected using four tools: Structured interview questionnaire, the Community Healthy Activities Model Program for Seniors (CHAMPS), the Cognitive and Leisure Activity Scale (CLAS), and the WHO Quality of Life-BREF (WHOQOL-BREF).
Results: The findings revealed statistically significant improvements among participants following the intervention. Physical activity increased from 10% to 52%, cognitive engagement improved from 16% to 62%, and quality of life enhanced from 9% to 58%. Additionally, a highly significant positive correlation (p < 0.01) was observed between physical activity, cognitive training, and quality of life both before and after the intervention.
Conclusion: The combined physical activity and cognitive training intervention was effective in enhancing quality of life among older adults.
Recommendations: The combined intervention should be applied continuously in the current study setting and expanded to similar environments to assess its long-term sustainability and to support evidence-based aging care.
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Alley, S. J., Waters, K. M., Parker, F., Peiris, D. L. I. H. K., Fien, S., Rebar, A. L., & Vandelanotte, C. (2024). The effectiveness of digital physical activity interventions in older adults: A systematic umbrella review and meta-meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 21(1), 144. https://doi.org/10.1186/s12966-024-01560-5
Chan, C. C. K., Chen, H., McGrath, C., Klineberg, I., Wong, G. H. Y., & Chen, H. (2024). Impact of Social Wellbeing on Tooth Loss and Cognition: A Scoping Review. Journal of Dentistry, 105376.
Chen, S., Li, Z., Zhang, Y., Chen, S., & Li, W. (2025). Food insecurity, physical activity, and sedentary behavior in middle to older adults. Nutrients, 17(6), 1011. https://doi.org/10.3390/nu17061011
Conger, S. A., Herrmann, S. D., Willis, E. A., Nightingale, T. E., Sherman, J. R., & Ainsworth, B. E. (2024). 2024 Wheelchair Compendium of Physical Activities: An update of activity codes and energy expenditure values. Journal of Sport and Health Science, 13(1), 18–23. https://doi.org/10.1016/j.jshs.2023.06.002
Esmaeili, F., Ghasemian, M., & Salman, Z. (2023). Investigating the effects of combined physical-cognitive exercises on executive functions: A home-based exercise approach. Physical Treatments-Specific Physical Therapy Journal, 13(1), 67–76. https://dx.doi.org/10.32598/jpt.13.1.67
Farrag, N., Abou-Elwafa, H. S., & El-Gilany, A. H. (2019). Prevalence and predictors of physical activity among community-dwelling older adults in Mansoura, Egypt. American Journal of Preventive Medicine and Public Health, 5(1), 1. https://doi.org/10.11648/j.ajpm.20190501.11
Ferretti-Rebustini, R. E. D. L., Souza-Talarico, J. N. D., Fhon, J. R. S., & Greenberg, S. A. (2022). The role of assessment in competence-based gerontological advanced practice nursing. Revista da Escola de Enfermagem da USP, 56, e20220072. https://doi.org/10.1590/1980-220X-REEUSP-2022-0072
Fiorilli, G., Buonsenso, A., Centorbi, M., Calcagno, G., Iuliano, E., Angiolillo, A., & Di Costanzo, A. (2022). Long term physical activity improves quality of life perception, healthy nutrition, and daily life management in elderly: A randomized controlled trial. Nutrients, 14(12), 2527. https://doi.org/10.3390/nu14122527
Galvin, J. E., Tolea, M. I., & Chrisphonte, S. (2021). The Cognitive & Leisure Activity Scale (CLAS): A new measure to quantify cognitive activities in older adults with and without cognitive impairment. Alzheimer's & dementia: translational research & clinical interventions, 7(1), e12134.
Gobbens, R. J., & Remmen, R. (2019). The effects of sociodemographic factors on quality of life among people aged 50 years or older are not unequivocal: comparing SF-12, WHOQOL-BREF, and WHOQOL-OLD. Clinical interventions in aging, 14, 231.
Gui, W., Cui, X., Miao, J., Zhu, X., & Li, J. (2024). The effects of simultaneous aerobic exercise and video game training on executive functions and brain connectivity in older adults. The American Journal of Geriatric Psychiatry, 32(10), 1244–1258. https://doi.org/10.1016/j.jagp.2024.06.005
Guo, W., Zang, M., Klich, S., Kawczyński, A., Smoter, M., & Wang, B. (2020). Effect of combined physical and cognitive interventions on executive functions in older adults: A meta-analysis of outcomes. International Journal of Environmental Research and Public Health, 17(17), 6166. https://doi.org/10.3390/ijerph17176166
Hekler, E. B., Buman, M. P., Haskell, W. L., Conway, T. L., Cain, K. L., Sallis, J. F., ... & King, A. C. (2012). Reliability and validity of CHAMPS self-reported sedentary-to-vigorous intensity physical activity in older adults. Journal of Physical Activity and Health, 9(2), 225-236.
Ho, M. H., Peng, C. Y., Liao, Y., & Yen, H. Y. (2024). Efficacy of a wearable activity tracker with step-by-step goal-setting on older adults’ physical activity and sarcopenia indicators: Clustered trial. Journal of Medical Internet Research, 26, e60183. https://doi.org/10.2196/60183
Indrakumar, J., & Silva, S. (2024). Physical activity in the older adults: A review of the benefits and recommendations for promoting healthy aging through exercise. Journal of the Indian Academy of Geriatrics, 20(4), 207–213. https://doi.org/10.4103/jiag.jiag_65_24
Kim, H. R., Woo, S. H., Seo, J. P., So, W. Y., & Bae, J. S. (2024). Satisfaction with the exercise program and successful aging among older adults who exercise regularly: The multiple mediation of physical self-efficacy and exercise adherence. In Healthcare (Vol. 12, No. 20, p. 2054). MDPI.
Kunrit, P., Tanthanapanyakorn, P., Khantikulanon, N., Mungkhunthod, S., Praserttai, C., Rungrungrueang, S., & Phonmamuang, W. (2025). Effectiveness of a brain exercise program using game-based cognitive enhancement to reduce mild cognitive impairment among older adults in Pathum Thani Province, Thailand: A quasi-experimental study. Osong Public Health and Research Perspectives, 16(1), 59.
Li, N., Ye, Q., Deng, Q., Wang, Y., Hu, J., Li, X., ... & Zhou, J. (2023). Physical activity intervention for leisure-time activity levels among older adults: a cluster randomized trial. JAMA Network Open, 6(9), e2333195-e2333195
Longhini, J., Marzaro, C., Bargeri, S., Palese, A., Dell’Isola, A., Turolla, A., ... & Rossettini, G. (2024). Wearable devices to improve physical activity and reduce sedentary behaviour: An umbrella review. Sports Medicine - Open, 10(1), 9.
Marafioti, G., Cardile, D., Culicetto, L., Quartarone, A., & Lo Buono, V. (2024). The impact of social cognition deficits on quality of life in multiple sclerosis: A scoping review. Brain Sciences, 14(7), 691.
Mariani, N. W., Sari, N. L. P. D. Y., & Dewi, S. P. A. A. P. (2025). The effect of sports classes on the quality of life of older adults in Sidakarya Village. Jurnal Kesehatan, 14(01), 27–30.
Matsuyama, S., Lu, Y., Aida, J., Tanji, F., & Tsuji, I. (2022). Association between number of remaining teeth and healthy aging in Japanese older people: The Ohsaki Cohort 2006 Study. Geriatrics & Gerontology International, 22(1), 68-74.
Meng, Q., Yin, H., Wang, S., Shang, B., Meng, X., Yan, M., & Chen, L. (2022). The effect of combined cognitive intervention and physical exercise on cognitive function in older adults with mild cognitive impairment: A meta-analysis of randomized controlled trials. Aging Clinical and Experimental Research, 34(2), 261–276.
Moradi, F., Askarizadeh, G., & Bagheri, M. (2024). Effects of ImproveCog cognitive stimulation program on cognitive functions in elderly patients with chronic obstructive pulmonary disease. Iranian Red Crescent Medical Journal, 26(1).
Moudi, A., Shahinfar, S., Razmara, M. R., & Salehiniya, H. (2020). Is the quality of life different in single and remarried elderly? Journal of Education and Health Promotion, 9.
Muñoz-Perete, J. M., Carcelén-Fraile, M. D. C., Cano-Sánchez, J., Aibar-Almazán, A., Castellote-Caballero, Y., Mesas-Aróstegui, M. A., & Hita-Contreras, F. (2025). Combined physical–cognitive therapies for the health of older adults with mild cognitive impairment: A systematic review and meta-analysis. In Healthcare (Vol. 13, No. 6, p. 591). MDPI.
paggetti, A., Druda, Y., Sciancalepore, F., Della Gatta, F., Ancidoni, A., Locuratolo, N., & Lacorte, E. (2025). The efficacy of cognitive stimulation, cognitive training, and cognitive rehabilitation for people living with dementia: A systematic review and meta-analysis. GeroScience, 47(1), 409–444.
Purba, F. D., Kumalasari, A. D., Novianti, L. E., Kendhawati, L., Noer, A. H., & Ninin, R. H. (2021). Marriage and quality of life during COVID-19 pandemic. Plos one, 16(9), e0256643.
Saez-Gutierrez, S., Fernandez-Rodriguez, E. J., Sanchez-Gomez, C., Garcia-Martin, A., Polo-Ferrero, L., & Barbero-Iglesias, F. J. (2024). Effectiveness of different neurocognitive intervention approaches on functionality in healthy older adults: A systematic review. Behavioral Sciences, 14(2), 87.
Samadarshi, S. C. A., Taechaboonsermsak, P., Tipayamongkholgul, M., & Yodmai, K. (2021). Quality of life and associated factors amongst older adults in a remote community, Nepal. Journal of Health Research, 36 (1), 56-67. DOI 10.1108/JHR-01-2020-0023
Setiawan, C., Ramadhani, A. N., & Rahayu, U. B. (2025). Effectiveness of low-impact aerobic exercise to improve cardiorespiratory fitness and quality of life in elderly. Althea Medical Journal, 12(1), 44–50.
Shi, Y., Xie, X. Y., Lao, A. D., Shao, L., Wang, Z. A., & Zhang, J. E. (2025). Prevalence of physical inactivity and its determinants among older adults living in nursing homes: A cross-sectional study based on COM-B model. Journal of Clinical Nursing, 34(1), 204–217.
Silveira-Rodrigues, J. G., Nogueira, N. G. D. H. M., Faria, L. O., Pereira, D. S., & Soares, D. D. (2023). Combined training improves executive functions without changing brain-derived neurotrophic factor levels of middle-aged and older adults with type 2 diabetes. Experimental and Clinical Endocrinology & Diabetes, 131(6), 345–353.
Steinberg, N., Parisi, J. M., Feger, D. M., Clay, O. J., Willis, S. L., Ball, K. K., ... & Rebok, G. W. (2023). Rural-urban differences in cognition: Findings from the advanced cognitive training for independent and vital elderly trial. Journal of Aging and Health, 35(9_suppl), 107S–118S.
Sullivan, G. M. (2024). Benefits of exercise for older adults. In Exercise for Aging Adults: A Guide for Practitioners (pp. 15–28). Cham: Springer International Publishing.
Sung, C. M., Lee, T. Y., Chu, H., Liu, D., Lin, H. C., Pien, L. C., ... & Chou, K. R. (2023). Efficacy of multi-domain cognitive function training on cognitive function, working memory, attention, and coordination in older adults with mild cognitive impairment and mild dementia: A one-year prospective randomised controlled trial. Journal of Global Health, 13, 04069.
Teng, G., Xia, H., Li, Q., & Chen, A. (2025). Improving executive function in children and adolescents with cognitive-engaging physical activity: A systematic review and multilevel meta-analysis. Journal of Developmental & Behavioral Pediatrics, 46(1), e76–e82. https://doi.org/10.1097/DBP.0000000000001142
Teno, S. C., Silva, M. N., & Júdice, P. B. (2024). Associations between domains of sedentary behavior, well-being, and quality of life–a cross-sectional study. BMC Public Health, 24(1), 1756. https://doi.org/10.1186/s12889-024-14872-1
Tsiakiri, A., Plakias, S., Vlotinou, P., Athanasouli, P., Terzoudi, A., Kyriazidou, S., & Christidi, F. (2025). Innovative health promotion strategies: A 6-month longitudinal study on computerized cognitive training for older adults with minor neurocognitive disorders. European Journal of Investigation in Health, Psychology and Education, 15(3), 34. https://doi.org/10.3390/ejihpe15030034
United Nations, Department of Economic and Social Affairs, Population Division (2020). World Population Ageing 2019 (ST/ESA/SER.A/444). Retrieved (April 23, 2021), fromhttp://creativecommons.org/licenses/by/3.0/igo/
World Health Organization (2022): Aging, overview, World Health Organization.https://www.who.int/health-topics/ageing#tab=tab_1
World Health Organization. (1998). Programme on mental health: WHOQOL user manual (No. WHO/HIS/HSI Rev. 2012.03). World Health Organization.
Yang, Q., Zhang, Y., & Li, S. (2024). The impact of mind–body exercise on the quality of life in older adults: The chain mediation effect of perceived social support and psychological resilience. Frontiers in Public Health, 12, 1446295. https://doi.org/10.3389/fpubh.2024.1446295
Yu, R., Leung, G., & Woo, J. (2021). Randomized controlled trial on the effects of a combined intervention of computerized cognitive training preceded by physical exercise for improving frailty status and cognitive function in older adults. International journal of environmental research and public health, 18(4), 1396.
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