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.