Effects of combined aerobic and resistance training compared to aerobic training alone on physical fitness and cognitive function in overweight and obese older adults A randomized controlled trial
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Abstract
The problem of obesity among older adults is becoming increasingly serious, leading to declines in physical fitness and cognitive function. While aerobic exercise (AE) is widely recommended for improving cardiometabolic health, combining it with resistance training (CARE) may yield broader functional benefits. This study aimed to evaluate and contrast the impacts of AE and CARE interventions on physical fitness and cognitive performance among older adults with overweight or obesity. A 12-week randomised controlled trial was conducted involving 46 overweight and obese older adults. Participants were randomized to aerobic exercise (AE) or AE + resistance training (CARE). Outcomes included body composition, senior fitness, and neuropsychological assessments. Both improved, with distinct effects: AE yielded greater reductions in weight, BMI, fat mass, and waist-hip ratio; CARE increased skeletal muscle mass, had larger strength gains, and showed greater improvements in Mini-Mental State Examination and memory tasks. Both benefit physical and cognitive outcomes in obese older adults. AE is particularly effective for fat reduction, while CARE confers additional advantages in muscle preservation, strength, and cognition. CARE may therefore represent a more comprehensive intervention to enhance health aging and maintain daily independence in this population.
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References
Andersson, E. A., Frank, P., Pontén, M., Ekblom, B., Ekblom, M., Moberg, M., & Sahlin, K. (2017). Improving strength, power, muscle aerobic capacity, and glucose tolerance through short-term progressive strength training among elderly people. Journal of Visualized Experiments (JoVE), (125), e55518. https://doi.org/10.3791/55518
Baek, M. J., Kim, K., Park, Y. H., & Kim, S. (2016). The validity and reliability of the mini-mental state examination-2 for detecting mild cognitive impairment and Alzheimer's disease in a Korean population. PloS one, 11(9), e0163792. https://doi.org/10.1371/journal.pone.0163792
Bai, X., Soh, K. G., Omar Dev, R. D., Talib, O., Xiao, W., Soh, K. L., ... & Casaru, C. (2022). Aerobic exercise combination intervention to improve physical performance among the elderly: a systematic review. Frontiers in Physiology, 12, 798068. https://doi.org/10.3389/fphys.2021.798068
Bhattacharya, P. K., Deka, K., & Roy, A. (2016). A community-based study to assess test-retest reliability of senior fitness test in the geriatric population in a Northeastern Indian city. Int J Med Sci Public Health, 5, 1606-1612. https://doi.org/10.5455/ijmsph.2016.21112015262
Burich, R., Teljigović, S., Boyle, E., & Sjøgaard, G. (2015). Aerobic training alone or combined with strength training affects fitness in elderly: randomized trial. European journal of sport science, 15(8), 773-783. https://doi.org/10.1080/17461391.2015.1060262
Cangoz, B., Karakoc, E., & Selekler, K. (2009). Trail Making Test: normative data for Turkish elderly population by age, sex and education. Journal of the neurological sciences, 283(1-2), 73-78. https://doi.org/10.1016/j.jns.2009.02.313
Caterson, I. D., Hubbard, V., Bray, G. A., Grunstein, R., Hansen, B. C., Hong, Y., ... & Smith Jr, S. C. (2004). Prevention Conference VII: Obesity, a worldwide epidemic related to heart disease and stroke: Group III: worldwide comorbidities of obesity. Circulation, 110(18), e476-e483. https://doi.org/10.1161/01.CIR.0000140114.83145.59
Cefis, M., Chaney, R., Wirtz, J., Méloux, A., Quirié, A., Leger, C., ... & Garnier, P. (2023). Molecular mechanisms underlying physical exercise-induced brain BDNF overproduction. Frontiers in molecular neuroscience, 16, 1275924. https://doi.org/10.3389/fnmol.2023.1275924
Chen, K., Shen, Z., Gu, W., Lyu, Z., Qi, X., Mu, Y., ... & Meinian Investigator Group. (2023). Prevalence of obesity and associated complications in China: a cross‐sectional, real‐world study in 15.8 million adults. Diabetes, Obesity and Metabolism, 25(11), 3390-3399. https://doi.org/10.1111/dom.15238
Cortes, T. M., Chae, K., Foy, C. M., Houston, D. K., & Beavers, K. M. (2025). The impact of lifestyle‐based weight loss in older adults with obesity on muscle and bone health: a balancing act. Obesity, 1-19. https://doi.org/10.1002/oby.24229
Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., ... & Zamboni, M. (2019). Sarcopenia: revised European consensus on definition and diagnosis. Age and ageing, 48(1), 16-31. https://doi.org/10.1093/ageing/afy169
Czartoryski, P., Garcia, J., Manimaleth, R., Napolitano, P., Watters, H., Weber, C., ... & Antonio, J. (2020). Body composition assessment: A comparison of the DXA, Inbody 270, and Omron. Journal of Exercise and Nutrition, 3(1). Retrieved from [Accessed 2025, 04 November]: https://journalofexerciseandnutrition.com/index.php/JEN/article/view/57/50
Deng, M., Tang, F., & Zhu, Z. (2025). Altered cognitive function in obese patients: relationship to gut flora. Molecular and Cellular Biochemistry, 480(6), 3553-3567. https://doi.org/10.1007/s11010-024-05201-y
Ferris, L. T., Williams, J. S., & Shen, C. L. (2007). The effect of acute exercise on serum brain-derived neurotrophic factor levels and cognitive function. Medicine & Science in Sports & Exercise, 39(4), 728-734. https://doi.org/10.1249/mss.0b013e31802f04c7
Fielding, R. A. (1995). The role of progressive resistance training and nutrition in the preservation of lean body mass in the elderly. Journal of the American College of Nutrition, 14(6), 587-594. https://doi.org/10.1080/07315724.1995.10718547
Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I. M., ... & Swain, D. P. (2011). American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine and science in sports and exercise, 43(7), 1334-1359. https://doi.org/10.1249/MSS.0b013e318213fefb
Harvey, P. D. (2019). Domains of cognition and their assessment. Dialogues in clinical neuroscience, 21(3), 227-237. https://doi.org/10.31887/DCNS.2019.21.3/pharvey
Heintz Walters, B., Huddleston, W. E., O'Connor, K., Wang, J., Hoeger Bement, M., & Keenan, K. G. (2021). The role of eye movements, attention, and hand movements on age-related differences in pegboard tests. Journal of neurophysiology, 126(5), 1710-1722. https://doi.org/10.1152/jn.00629.2020
Hesseberg, K., Bentzen, H., & Bergland, A. (2015). Reliability of the senior fitness test in Community‐dwelling older people with cognitive impairment. Physiotherapy Research International, 20(1), 37-44. https://doi.org/10.1002/pri.1594
Hu, J., Huang, B., & Chen, K. (2024). The impact of physical exercise on neuroinflammation mechanism in Alzheimer's disease. Frontiers in Aging Neuroscience, 16, 1444716. https://doi.org/10.3389/fnagi.2024.1444716
Ihalainen, J. K., Schumann, M., Eklund, D., Hämäläinen, M., Moilanen, E., Paulsen, G., ... & Mero, A. A. (2018). Combined aerobic and resistance training decreases inflammation markers in healthy men. Scandinavian journal of medicine & science in sports, 28(1), 40-47. https://doi.org/10.1111/sms.12906
Johnson, R. C., McClearn, G. E., Yuen, S., Nagoshi, C. T., Ahern, F. M., & Cole, R. E. (1985). Galton's data a century later. American Psychologist, 40(8), 875-892. https://doi.org/10.1037/0003-066X.40.8.875
Marinus, N., Hansen, D., Feys, P., Meesen, R., Timmermans, A., & Spildooren, J. (2019). The impact of different types of exercise training on peripheral blood brain-derived neurotrophic factor concentrations in older adults: a meta-analysis. Sports medicine, 49(10), 1529-1546. https://doi.org/10.1007/s40279-019-01148-z
Marzolini, S., Oh, P. I., & Brooks, D. (2012). Effect of combined aerobic and resistance training versus aerobic training alone in individuals with coronary artery disease: a meta-analysis. European journal of preventive cardiology, 19(1), 81-94. https://doi.org/10.1177/1741826710393197
McGlory, C., Devries, M. C., & Phillips, S. M. (2017). Skeletal muscle and resistance exercise training; the role of protein synthesis in recovery and remodeling. Journal of applied physiology, 122(3), 541-548. https://doi.org/10.1152/japplphysiol.00613.2016
Muscella, A., Stefàno, E., Lunetti, P., Capobianco, L., & Marsigliante, S. (2020). The regulation of fat metabolism during aerobic exercise. Biomolecules, 10(12), 1699. https://doi.org/10.3390/biom10121699
Nakamura, N., & Muraoka, I. (2018). Resistance training augments cerebral blood flow pulsatility: cross-sectional study. American Journal of Hypertension, 31(7), 811-817. https://doi.org/10.1093/ajh/hpy034
Ostrosky‐Solís, F., & Lozano, A. (2006). Digit span: Effect of education and culture. International Journal of Psychology, 41(5), 333-341. https://doi.org/10.1080/00207590500345724
Pollock, M. L., Gaesser, G. A., Butcher, J. D., Després, J. P., Dishman, R. K., Franklin, B. A., & Garber, C. E. (1998). ACSM position stand: the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Journals AZ Medicine & Science, 30(6), 975-991. https://doi.org/10.1249/00005768-199806000-00032
Rikli, R. E., & Jones, C. J. (1999). Development and validation of a functional fitness test for community-residing older adults. Journal of aging and physical activity, 7(2), 129-161. https://doi.org/10.1123/japa.7.2.129
Rodrigues, F., Teixeira, J. E., Monteiro, A. M., & Forte, P. (2023). The effects of 6-month multi-component exercise intervention on body composition in aged women: A single-arm experimental with follow-up study. Applied Sciences, 13(10), 6163. https://doi.org/10.3390/app13106163
Sánchez-Aranda, L., Fernández-Ortega, J., Martín-Fuentes, I., Toval, Á., Jurak, G., Ruiz, J. R., ... & Ortega, F. B. (2024). Reliability and criterion validity of a low-cost handgrip dynamometer: The Camry. medRxiv, 2024-06. https://doi.org/10.1101/2024.06.25.24309304
Smith Jr, S. C., Clark, L. T., Cooper, R. S., Daniels, S. R., Kumanyika, S. K., Ofili, E., ... & Tiukinhoy, S. D. (2005). Discovering the full spectrum of cardiovascular disease: Minority Health Summit 2003: report of the Obesity, Metabolic Syndrome, and Hypertension Writing Group. Circulation, 111(10), e134-e139. https://doi.org/10.1161/01.CIR.0000157743.54710.04
Suo, C., Singh, M. F., Gates, N., Wen, W., Sachdev, P., Brodaty, H., ... & Valenzuela, M. J. (2016). Therapeutically relevant structural and functional mechanisms triggered by physical and cognitive exercise. Molecular psychiatry, 21(11), 1633-1642. https://doi.org/10.1038/mp.2016.19
Villareal, D. T., Aguirre, L., Gurney, A. B., Waters, D. L., Sinacore, D. R., Colombo, E., ... & Qualls, C. (2017). Aerobic or resistance exercise, or both, in dieting obese older adults. New England Journal of Medicine, 376(20), 1943-1955. https://doi.org/10.1056/NEJMoa1616338
World Health Organization. (2025 June 20). Obesity and overweight. Retrieved from [Accessed 2025, 04 November]: https://www.who.int/zh/news-room/fact-sheets/detail/obesity-and-overweight
Zamboni, M., Mazzali, G., Fantin, F., Rossi, A., & Di Francesco, V. (2008). Sarcopenic obesity: a new category of obesity in the elderly. Nutrition, metabolism and cardiovascular diseases, 18(5), 388-395. https://doi.org/10.1016/j.numecd.2007.10.002