Meekum (2025) Enhancing Global Cognition and Executive Functions Through Water Based Exercise in Mild Cognitive Impairment A Randomized Controlled Trial

Water-Based Exercise Enhances Cognitive Function in Older Adults with Mild Cognitive Impairment

Introduction: Tackling MCI Through Innovative Approaches

Mild cognitive impairment (MCI) is a precursor to dementia, affecting memory, attention, and executive functioning in older adults. As pharmacological interventions show limited efficacy, researchers are turning to alternative therapies. This 2025 randomized controlled trial by Meekum et al. explores the cognitive benefits of water-based aerobic exercise, with and without cognitive training, in older adults diagnosed with MCI.

Study Design: Exercise with and without Cognitive Stimulation

The study recruited 46 participants aged 65 and older with clinically confirmed MCI. They were randomly assigned to either:

W Group: Water-based aerobic exercise only
W-COG Group: Water-based aerobic exercise + cognitive training

Both groups participated in 60-minute sessions, three times per week for 12 weeks. The W-COG group was given additional memory-based challenges during exercise to engage cognitive domains like attention, flexibility, and recall.

Results: Improved Cognition and Executive Function

Significant improvements were observed in:

Global cognition (Montreal Cognitive Assessment – MoCA scores) in both groups
Executive function and visuospatial ability, measured by Trail Making Tests A & B
Cognitive flexibility and shifting abilities, particularly in the W-COG group

Notably, 77.7% of W participants and 89% of W-COG participants improved their cognitive classification to “normal range” (MoCA ≥25). The W-COG group saw greater benefits in complex cognitive tasks, indicating added value from combined cognitive-physical training.

Conclusion: A Promising Non-Pharmacological Strategy

This study highlights that water-based exercise is a safe and effective intervention to enhance cognitive function in older adults with MCI. When combined with cognitive training, the benefits are even more profound—particularly for executive functioning. These findings support incorporating aquatic exercise into geriatric care programs aimed at delaying cognitive decline.