Researchers studied 161 older adults with mild memory problems to see if exercise, brain training games, and vitamin D could help them walk better and prevent falls. Over 20 weeks, people who did aerobic exercise combined with strength training and computer brain games showed the biggest improvements in walking speed and had significantly fewer falls a year later. Interestingly, adding vitamin D supplements didn’t help and actually made walking less stable. The combination of physical exercise and mental training together worked better than either one alone.

The Quick Take

  • What they studied: Whether combining exercise, brain training games, and vitamin D supplements could help older adults with early memory loss walk better and prevent falls.
  • Who participated: 161 people between ages 65 and 84 who had mild cognitive impairment (early memory and thinking problems but not full dementia). They were divided into different groups that received different combinations of treatments.
  • Key finding: People who did aerobic exercise plus strength training combined with computerized brain training games walked about 3 inches faster and had 76% fewer falls after one year compared to those who didn’t exercise. Vitamin D alone didn’t help and actually made walking less stable.
  • What it means for you: If you’re an older adult with memory concerns, combining regular exercise with brain training games may significantly reduce your fall risk and improve your mobility. However, vitamin D supplements alone won’t provide these benefits and may actually be counterproductive.

The Research Details

This was a carefully designed research study where 161 older adults were randomly assigned to different treatment groups over 20 weeks. Some groups did aerobic exercise (like walking or cycling) combined with strength training, some did computerized brain training games, some got vitamin D supplements, and some got combinations of these treatments. The researchers measured how fast people walked, how steady their walking was, and how many falls they had at the start, after 6 months, and after 12 months.

The study used what’s called a ‘fractional factorial design,’ which is a smart way to test multiple treatments at once to see which combinations work best together. This allowed researchers to see not just if each treatment worked alone, but also if treatments worked better when combined together—what scientists call ‘synergistic effects.’

Participants were recruited from September 2016 to April 2020, and researchers carefully tracked them for a full year after the intervention ended to see if benefits lasted.

This research approach is important because older adults with memory problems often struggle with both thinking and physical abilities at the same time. By testing combinations of treatments together, researchers could discover whether combining exercise with brain training creates better results than doing them separately. This helps doctors and patients make smarter decisions about which treatments to combine for the best outcomes.

This study is a randomized controlled trial, which is considered one of the strongest types of research because people were randomly assigned to different groups, reducing bias. The study tracked participants for a full year after treatment ended, which shows whether benefits lasted over time. However, the sample size of 161 people is moderate, and results should be confirmed with larger studies. The study was published in a reputable medical journal focused on aging research.

What the Results Show

All groups that did exercise-based activities improved their walking speed by about 7.5 centimeters per second (roughly 3 inches faster) after 6 months. This improvement was maintained at the 12-month follow-up.

The most impressive results came from combining exercise with brain training games. This combination reduced falls by 76% at the 12-month mark compared to the control group. In other words, people in this group had about one-quarter the number of falls compared to those who didn’t exercise or do brain training.

Injurious falls (falls that caused injury) were also significantly reduced in the exercise groups, dropping by about 62% at 12 months. This is particularly important because falls that cause injury are a major health concern for older adults.

The benefits weren’t immediate—at 6 months, the fall reduction wasn’t quite statistically significant, but by 12 months the protection was clear and strong. This suggests that the brain and body need time to adapt to the training.

An unexpected finding was that vitamin D supplementation did not improve outcomes and actually increased gait variability—a measure of how unsteady someone’s walking pattern is. Higher gait variability is associated with increased fall risk, so adding vitamin D appeared to be counterproductive. This suggests that vitamin D supplementation at this dose (10,000 IU three times per week) may not be beneficial for this population and could potentially be harmful.

Previous research has shown that exercise helps older adults maintain mobility and that cognitive training can improve brain function. However, this study is one of the first to systematically test whether combining these two approaches creates better results than either alone. The finding that the combination works better than individual treatments aligns with emerging research suggesting that brain and body health are interconnected, especially in people with cognitive impairment.

The study included 161 people, which is a moderate sample size—larger studies would provide more confidence in the results. The participants were primarily from a specific geographic area and may not represent all older adults with memory problems. The study didn’t track whether people continued exercising after the formal program ended, so we don’t know if the benefits would last if people stopped exercising. Additionally, the vitamin D dose used was quite high, so results might differ with lower doses.

The Bottom Line

For older adults with mild cognitive impairment: Combine aerobic exercise (like brisk walking, cycling, or swimming) with strength training and computerized brain training games. This combination appears to significantly reduce fall risk and improve walking ability. Vitamin D supplementation at high doses is not recommended based on this evidence. Moderate confidence in these recommendations based on this single study; larger confirmatory studies would increase confidence.

This research is most relevant for older adults (65+) who have noticed early memory or thinking problems but don’t have full dementia. It’s also important for family members, caregivers, and healthcare providers working with this population. People with severe dementia or those unable to exercise should consult their doctor before starting any program. Those already taking vitamin D should discuss this research with their healthcare provider.

Walking speed improvements appeared within 6 months of starting the program. However, the most significant fall reduction took 12 months to become statistically significant. This suggests people should commit to at least a year of consistent exercise and brain training to see maximum benefits. Benefits may continue to improve beyond 12 months with continued participation.

Want to Apply This Research?

  • Track weekly exercise sessions (aerobic + strength training) and daily brain training game completion. Set a goal of 3-4 exercise sessions per week and 15-20 minutes of brain training daily. Log any falls or near-falls to monitor progress over time.
  • Use the app to schedule and remind users of exercise sessions and brain training games. Create a simple dashboard showing weekly completion rates and fall incidents. Celebrate milestones (e.g., 4 weeks of consistent exercise) to maintain motivation.
  • Track monthly trends in exercise adherence and fall frequency. Compare fall rates month-to-month and quarter-to-quarter. Monitor perceived walking stability through user self-reports. Send monthly summaries showing progress toward fall reduction goals.

This research suggests that exercise combined with brain training may help reduce falls in older adults with mild cognitive impairment, but individual results vary. This information is not a substitute for professional medical advice. Before starting any new exercise program or making changes to supplements, consult with your doctor, especially if you have existing health conditions, take medications, or have concerns about falls. The findings about vitamin D supplementation should not be applied to other populations or dosages without medical guidance. Always discuss any new health interventions with your healthcare provider.