The Effectiveness of Selected Perceptual-Motor Exercises on Working Memory and Quality of Life of Elderly Women

Cognitive disorders and decline in quality of life are common changes in old age that cause a wide range of problems. In order to increase the level of health and performance of the ever-increasing older adults’ population, it is necessary to understand their conditions and needs. Therefore, the current research was conducted with the aim of investigating the effectiveness of selected perceptual-motor exercises on working memory and quality of life in older women. This research was a semi-experimental one, with pretest-posttest design with a control group. The statistical population of this research included all inactive older women over 60 years old living in nursing homes in Tehran. The sample of the study included 40 people selected using convenience sampling and based on the inclusion criteria and randomly assigned into control and experimental groups. The participants completed the Folstein’s mini–mental state examination, the World Health Organization Quality of Life and the Wechsler Memory Questionnaire. The experimental group participated in the perceptual-motor training program for eight weeks, three 45-minute sessions per week. The control group did their daily activities during this time. After the training program, both groups completed the questionnaires again. To analysis the data, Univariate analysis of covariance (ANCOVA) in SPSS-20 software were used (P≤.05). The results of ANCOVA after the training intervention showed a significant improvement in the posttest scores of the experimental group in terms of working memory (P=.007) and quality of life (P=.001) compared to that of the control group. According to the results of this research, it is suggested to older adults to use perceptual-motor exercises in order to improve their cognitive and physical health, according to their individual ability and environmental facilities.
EXTENDED ABSTRACT
Introduction
During aging, factors such as cognitive and physical impairments and decreased independence affect the quality of life among older adults. Cognitive impairments influence daily activities in older adults and make them reliant on care. Beyond their psychological and social burdens, these impairments often incur high medical expenses. Therefore, they need to be solved through suitable interventions. Decreased working memory alongside poor emotional regulation can affect negatively the mental health and the quality of life among older adults. Quality of life can predict the extent and impact of illnesses, injuries, and disabilities in older adults, and act as a suitable tool for assessing their mental health. Based on conducted studies, of effective methods in enhancing memory and quality of life among the older adults, one is perceptual-motor exercises. It is imperative to employ a low-cost, safe, simple exercise program with multifaceted effects, such as perceptual-motor exercises executable with minimal sports facilities.  Prior research has primarily focused on employing either perceptual or motor exercise methods separately, neglecting a combined exercise. Therefore, this study aimed to investigate the impact of combined perceptual-motor exercises on working memory and the quality of life in older adults.
Method
This study utilized a quasi-experimental approach with a pretest-posttest design with a control group. The statistical population included inactive older women over 60 years residing in nursing homes in Tehran, among whom 40 older individuals from one of these nursing homes were selected using convenience sampling and based on inclusion criteria and randomly assigned into experimental and control groups. Inclusion criteria included (1) scoring below the cutoff point in pretest questionnaires, (2) lack of regular physical exercises, (3) relative general health, (4) being illiterate, and (5) ability to participate in at least 90% of exercise sessions. Exclusion criteria included engaging in physical activity beyond the exercise program and using drugs or supplements affecting the participant's cognitive or physical state. Participants completed Folstein’s mini–mental state examination, world health organization quality of life questionnaire, and Wechsler memory scale. The experimental group participated in 45-minute sessions of a perceptual-motor program three times a week for eight weeks. The control group continued their daily activities without engaging in any specific organized physical exercises. Following the eight-week intervention, both groups completed the memory and quality of life questionnaires again. Data were analyzed by univariate analysis of covariance (ANCOVA) in SPSS-20.
Results
Before analyzing Data, it was determined that distribution of data in each group was normal, and the homogeneity assumption of variance was met. ANCOVA was utilized to assess the effectiveness of perceptual-motor exercises on working memory and quality of life. According to the results obtained from ANCOVA, it was demonstrated that there is a significant difference between the experimental and control groups in terms of working memory. Namely, considering the average score of working memory in the experimental group (M=60.62) compared to that of working memory in the control group (M=25.46) in the posttest, perceptual-motor exercises led to a significant increase in working memory in the experimented group. The effect size was equal to .88, signifying that 88% of the individual differences in working memory scores were attributed to the effect of perceptual-motor exercises. Hence, the first hypothesis of this study was confirmed. Besides, based on the average score of quality of life in the experimental group (M=134.69) compared to that of quality of life in the control group (M=107.33) in post-test, it was indicated that perceptual-motor exercises resulted in a significant increase in the quality of life in the experimental group. The effect size was .73, meaning that 73% of the individual differences in quality of life scores were due to the effect of perceptual-motor exercises. Therefore, the second hypothesis of the research was confirmed.
Conclusion
Cognitive impairments are a normal part of aging, impacting working memory and reducing responsiveness to environmental stimuli. Nowadays, it is recognized that exercise training, by enhancing oxygen supply to the brain and improving brain structure, can complement pharmacological approaches for the elderly. perceptual-motor exercises, combined with cognitive tasks, may enhance perceptual-motor processes and memory. Quality of life is a social phenomenon shaped, reproduced, and learned through social measures. Through exercise and learning new skills, older adults gain increased confidence and capability, leading to improved physical, mental, and emotional health. Regular physical activities enable older adults to maintain their independence and contribute better socially, ultimately enhancing their quality of life. Due to prevalent disabilities, physical issues, and reduced mobility, older adults cannot benefit from intensive intermittent exercises to improve their cognitive and motor issues. Based on the results of the current study, people working in this field are recommended to implement a low-cost exercise program that simultaneously focuses on cognitive and motor aspects, such as perceptual-motor exercises, to achieve better performance considering older adults’ conditions and environmental facilities.
Ethical Consideration
Ethical Code
This study was conducted as an intrauniversity research project with approval from the Islamic Azad University, Garmsar branch.
Financial Support
 This study was conducted as an intrauniversity research project funded by Islamic Azad University, Garmsar branch.
Authors’ Contributions
M.F.A: Conceptualization, methodology, software, validation, formal analysis, data curation, resources, writing - original draft, writing - review & editing, funding acquisition, project administration, supervision, visualization
Conflict of Interest
 The author had no conflicts of interest.
Acknowledgments
Gratitude is extended to the Deputy of Research at Islamic Azad University, Garmsar branch, for financial support in conducting this research. Heartfelt appreciation is also expressed to all older individuals who were participants of the current study.
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