ADAPTATION TO INTERMITTENT HYPOXIA-HYPEROXIA IMPROVES COGNITIVE PERFORMANCE AND EXERCISE TOLERANCE IN ELDERLY
For improvements in exercise tolerance and cognitive function in geriatric patients Multimodal training programs (MTP) are used as combination of physiotherapy, occupational therapy and cardiovascular training. Intermittent Hypoxic-Hyperoxic Training (IHHT), a modiﬁed type of intermittent hypoxic training (IHT) is proposed to be included in MTP to elicit more pronounced beneﬁcial effects in exercise tolerance and cognitive functions of geriatric patients likely by an additional pathway than a single MTP. Thirty four patients of the Geriatric Day Clinic aged between 64 and 92 years participated in the placebo controlled clinical trial. They were randomly assigned to receive MTP plus IHHT (experimental group - EG) or MTP plus placebo-breathing through a machine face mask (control group - CG) in a double blind fashion. Before and after the interventions course cognitive performance was assessed by the DementiaDetection-Test (DemTect) and the Clock-Drawing-Test (CDT), and functional exercise capacity - by the total distance of 6-Minute-Walk-Test (6MWT). After IHHT combined with MTP cognitive performance (DemTect) increased signiﬁcantly when compared to NG (+16,7 % vs. +0,39 %, p <0,001). The CDT indicated similar results with a signiﬁcant increase in the EG while the score of the CG even decreased (+10,7 % vs. -8 %, p =0,031). Concerning the functional exercise capacity, both groups improved the total distance in the 6MWT but with a signiﬁcantly larger increase in the EG compared to the CG (+24,1 % vs. +10,8 %, p =0,021). In addition, there was a signiﬁcant relationship between the changes of the 6MWT and the DemTect Scores and the CDT. IHHT contributed signiﬁcantly to improvements in cognitive performance and exercise capacity in elderly performing MTP. IHHT sessions are considered to be easily applicable to and well tolerated by geriatric patients up to 92 years.