Does Adding Mindfulness to Instability Resistance Training Enhance Dual-Task Mobility and Fall-Related Outcomes in Older Adults with Motoric Cognitive Risk Syndrome? A Randomized Controlled Trial.

BACKGROUND: Older adults with motoric cognitive risk syndrome (MCR) exhibit impairments in dual-task mobility. Non-pharmacological interventions, such as physical exercise and cognitive strategies, have been proposed to mitigate physical and cognitive decline. However, the effectiveness of combining these approaches remains unclear. OBJECTIVE: To evaluate the effects of instability resistance training (IRT) performed with or without mindfulness on mobility under single- and dual-task conditions and fall-related outcomes in older adults with MCR. METHODS: In this parallel-group randomized controlled trial, 56 community-dwelling older adults with MCR (≥65 years) were allocated to IRT or combined with mindfulness (IRT + Mind). Both groups trained twice weekly for 24 weeks. Primary outcomes included single- and dual-task Timed Up and Go (TUG). Secondary outcomes were dual-task cost, concern about falling (Falls Efficacy Scale-International), and balance confidence (Activities-specific Balance Confidence Scale). Outcomes were analyzed using generalized mixed models. RESULTS: For single-task TUG, a significant main effect of time was observed (p < .001), with similar improvements in both groups (0.62-0.80 s). Dual-task TUG performance improved over time for both cognitive conditions, with significant group × time interactions favoring the IRT group (p ≤ .049). Dual-task cost did not change significantly. Balance confidence improved significantly over time in both groups (mean increase ≈14 points; p < .001), whereas concern about falling remained unchanged. CONCLUSION: IRT improved mobility and confidence in balance in older adults with MCR. The addition of mindfulness did not provide incremental benefits, suggesting that motor-based training alone is sufficient to promote functional gains in this population.