Skip to main content

The effect of structured strength and balance training on cognitive function in frail, cognitive impaired elderly long-term care residents


Background and aims: The aim of the study was to assess the effect of structured strength and balance training on cognitive function in frail, geriatric, long-term care facility residents, aged 75 years or older, and additionally to evaluate the influence of training on various functional, physical and psychological parameters. Methods: Participants were randomly assigned to a training group or a control group. Physical training was performed three times a week for ten weeks in the training group. Muscle function was assessed by manual examination on a scale of 0–5. Cognitive function was tested with the Mini Mental State Examination (MMSE). In addition, scores for activities of daily living, mobility and depression were assessed. Results: 30 subjects with a mean age of 86.8 years completed the study. After 10 weeks of intervention in the training group, muscle strength increased from a mean of 3.75 to 4.44 points (p<0.001) and the mean MMSE score increased from 20.9 to 23.9 points (p=0.023). In the training group,the change in the MMSE score correlated significantly with change in muscle function, with a Pearson correlation coefficient of 0.750 (p=0.002). An increase in mean BMI from 23.8 to 25.0 kg/m2 (p=0.013) was also found in the training group, but no significant changes in scores for activities of daily living, mobility or depression. Compared with the control group, the change in the mean scores over the ten-week training period was significantly higher for the trained group with regard to muscle scores, BMI and lean body mass, but not for MMSE scores. Conclusions: Our findings reinforce the recommendation that structured strength and balance training should be implemented in long-term care facilities. Besides the well-known benefits of physical training, our findings showed that an improvement in cognitive function may also be possible.

This is a preview of subscription content, access via your institution.


  1. 1

    Fiatarone MA, O’Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 1994; 330: 1769–75.

    PubMed  Article  CAS  Google Scholar 

  2. 2.

    Charette SL, McEvoy L, Pyka G, et al. Muscle hypertrophy response to resistance training in older women. J Appl Physiol 1991; 70: 1912–6.

    PubMed  CAS  Google Scholar 

  3. 3.

    Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, Evans WJ. High-intensity strength training in nonagenarians. Effects on skeletal muscle. JAMA 1990; 263: 3029–34.

    CAS  Google Scholar 

  4. 4.

    Hurley BF, Roth SM. Strength training in the elderly: effects on risk factors for age-related diseases. Sports Med 2000; 30: 249–68.

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    Mazzeo RS, Tanaka H. Exercise prescription for the elderly: current recommendations. Sports Med 2001; 31: 809–18.

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Seguin R, Nelson ME. The benefits of strength training for older adults. Am J Prev Med 2003; 25 (Suppl): 141S–9S.

    Article  Google Scholar 

  7. 7.

    Wolfson L, Whipple R, Derby C, et al. Balance and strength training in older adults: intervention gains and Tai Chi maintenance. J Am Geriatr Soc 1996; 44: 498–506.

    PubMed  CAS  Google Scholar 

  8. 8.

    Heyn P, Abreu BC, Ottenbacher KJ. The effects of exercise training on elderly persons with cognitive impairment and dementia: a meta-analysis. Arch Phys Med Rehabil 2004; 85: 1694–704.

    PubMed  Article  Google Scholar 

  9. 9.

    Baum EE, Jarjoura D, Polen AE, Faur D, Rutecki G. Effectiveness of a group exercise program in a long-term care facility: a randomized pilot trial. J Am Med Dir Assoc 2003; 4: 74–80.

    PubMed  Article  Google Scholar 

  10. 10.

    Perrig-Chiello P, Perrig WJ, Ehrsam R, Staehelin HB, Krings F. The effects of resistance training on well-being and memory in elderly volunteers. Age Ageing 1998; 27: 469–75.

    PubMed  Article  CAS  Google Scholar 

  11. 11.

    Tsutsumi T, Don BM, Zaichkowsky LD, Delizonna LL. Physical fitness and psychological benefits of strength training in community dwelling older adults. Appl Human Sci 1997; 16: 257–66.

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    Janda V. [Muscle function diagnostics], 1st ed. Heidelberg: Verlag für Medizin, Dr. Ewald Fischer, 1979 (in German).

  13. 13.

    Bös K ed. [Handbook for motor tests: sports motor tests, motor function tests, questionnaires for physical sports activity and psychological diagnostics for sports], 2nd ed. Göttingen: Hogrefe, Verlag für Psychologie, 2001 (in German).

  14. 14.

    Kessler J, Markowitsch HJ, Denzler P. [Mini Mental Status Examination MMSE. German Version], Weinheim: Beltz-Verlag, 1990 (in German).

    Google Scholar 

  15. 15.

    Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.

    CAS  Google Scholar 

  16. 16.

    Tombaugh TN, McIntyre NJ. The Mini-Mental State Examination: a comprehensive review. J Am Geriatr Soc 1992; 40: 922–35.

    PubMed  CAS  Google Scholar 

  17. 17.

    Kafonek S, Ettinger WH, Roca R, Kittner S, Taylor N, German PS. Instruments for screening for depression and dementia in a long-term care facility. J Am Geriatr Soc 1989; 37: 29–34.

    PubMed  CAS  Google Scholar 

  18. 18.

    Mahoney FI, Barthel DW. Functional evaluation: the Barthel-Index. Maryland State Med J 1965; 14: 56–61.

    Google Scholar 

  19. 19.

    Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 1986; 34: 119–26.

    PubMed  CAS  Google Scholar 

  20. 20.

    Tinetti ME. A simple procedure for general screening for functional disability in elderly patients. Ann Intern Med 1990; 112: 699–706.

    PubMed  Article  Google Scholar 

  21. 21.

    Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982–1983; 17: 37–49.

    Article  Google Scholar 

  22. 22.

    Pollock ML, Franklin BA, Balady GJ, et al. AHA Science Advisory. Resistance exercise in individuals with and without cardiovascular disease: benefits, rationale, safety, and prescription: an advisory from the Committee on Exercise, Rehabilitation, and Prevention, Council on Clinical Cardiology, American Heart Association; Position paper endorsed by the American College of Sports Medicine. Circulation 2000; 101: 828–33.

    CAS  Google Scholar 

  23. 23.

    Hollmann W, Hettinger T. [Sports medicine. Basic principles for work, training and preventive medicine], 4th ed. Stuttgart: Schattauer Verlagsgesellschaft mbH, 2000 (in German).

    Google Scholar 

  24. 24.

    Fratiglioni L, Paillard-Borg S, Winblad B. An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurol 2004; 3: 343–53.

    PubMed  Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Thomas Dorner MD.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Dorner, T., Kranz, A., Zettl-Wiedner, K. et al. The effect of structured strength and balance training on cognitive function in frail, cognitive impaired elderly long-term care residents. Aging Clin Exp Res 19, 400–405 (2007).

Download citation


  • dementia
  • elderly
  • physical exercise