ClinicalTrials.gg
Enrolling by invitationNCT07728279Updated Nov 4, 2026

Impact of Respiratory Muscle Training on Cognition in Older Adults

An interventional study of Inspiratory Muscle Training in Older Adults, sponsored by Acibadem University. Enrolling by invitation at 1 site in Turkey (Türkiye). Open to participants aged 60 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-11-04.

Sponsored by Acibadem University · Not applicable, Interventional, and Treatment

Updated Nov 4, 2026Start date movedPrimary completion moved+3 moreGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
24
Allocation
Randomized
Ages
60 Years and older
Sex
All
01

Study summary

The increase in chronic diseases associated with aging leads to various physical limitations in older adults, negatively impacting fall risk, hospitalization rates, and overall mortality. While Inspiratory Muscle Training (IMT) is frequently utilized in rehabilitation programs due to its low cost and ease of use to enhance respiratory muscle strength, balance, and functional capacity, its potential effects on cognitive function remain unexamined.

The primary objective of this pilot randomized controlled trial is to investigate the effect of an 8-week Inspiratory Muscle Training (IMT) program on cognitive function in older adults. A secondary objective is to examine the relationship between cardiovascular risk factors and respiratory muscle strength in this population.

Researchers hypothesize that an 8-week IMT intervention will have a significant effect on cognitive function in older adults compared to a control group. To test this hypothesis, a total of 24 eligible older adults will be randomly assigned to either perform daily breathing exercises using an external device for 8 weeks or maintain their routine daily activities. Both groups will be assessed at baseline and after the 8-week period to evaluate changes in cognitive, functional, and physical parameters.

Read the detailed description

The decline in respiratory muscle strength, diminished cardiovascular capacity, and postural control impairments seen with aging significantly increase the risk of falls and physical limitations. Recent evidence suggests that Inspiratory Muscle Training (IMT) not only enhances respiratory muscle function but also yields systemic benefits in older adults, including improvements in, postural balance, and cerebral blood flow.

Despite these physiological benefits, current literature predominantly focuses on respiratory or cardiovascular outcomes, leaving the potential impact of IMT on cognitive function in the geriatric population largely unexplored. This pilot randomized controlled trial aims to address this gap by evaluating the comprehensive effects of an 8-week IMT protocol.

Following baseline evaluations, eligible older adults aged 60 and above will be randomized into two arms. The experimental group will undergo a progressive, 8-week IMT program, transitioning from supervised sessions to unsupervised home-based training with regular compliance checks and workload adjustments based on their maximum inspiratory capacity. The control group will continue their standard daily living activities without a specific breathing intervention. The study is designed to primarily observe changes in cognitive performance, while also tracking respiratory endurance, functional capacity, and lower extremity physical performance throughout the study duration.

02

Conditions studied

  • Older Adults

Keywords

  • inspiratory muscle training
  • cognition
  • Respiratory Muscle Training
  • Cognitive Function
  • older adults
03

In context

Lead sponsor

Acibadem University is the lead sponsor of 220 studies on the registry; 51 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
60 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Individuals aged 60 years and older
  • Ability to walk 10 meters independently
  • Literacy (ability to read and write)

Exclusion criteria

Exclusion Criteria:

  • Taking sedative or hypnotic medications,
  • Having a neurological disorder (history of stroke, Parkinson's disease, MS, dementia),
  • Presence of cardiovascular complications (individuals diagnosed with , pulmonary diseases, uncontrolled hypertension),
  • Postural abnormalities such as severe scoliosis or kyphosis,
  • Having communication problems

Criteria for withdrawal from the study:

  • Individuals who fail to attend 70% of the training sessions,
  • Individuals who are unable to participate in the interim or final assessments,
  • Individuals who develop an acute systemic illness,
  • Individuals who wish to withdraw from the study.
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
24 participants (estimated)

Study arms

  • Experimental
    Inspiratory Muscle Training Group

    Participants in this arm will undergo an 8-week Inspiratory Muscle Training (IMT) program using an external threshold loading device. The protocol consists of 30 breaths performed twice a day. For the first two weeks, sessions will be supervised, and the initial workload will be set between 30% and 50% of the participant's baseline Maximal Inspiratory Pressure (MIP). From the third week, training will be unsupervised at home with weekly compliance checks. To ensure progressive overload, MIP will be re-evaluated at the start of the 3rd, 5th, and 7th weeks, and the device resistance will be adjusted to 50% of the new MIP.

    Behavioral: Inspiratory Muscle Training

  • No intervention
    Control Group

    Participants allocated to this arm will not receive any specific breathing exercises or experimental interventions. They will be instructed to maintain their standard daily living activities throughout the 8-week study period. They will undergo the exact same baseline and post-intervention assessments as the experimental group to evaluate changes in cognitive function, respiratory muscle strength, endurance, functional capacity, and physical performance.

Interventions

  • BehavioralInspiratory Muscle Training

    The intervention consists of an 8-week progressive Inspiratory Muscle Training (IMT) program utilizing a spring-loaded threshold device (POWERbreathe Medic Classic). The daily protocol requires participants to perform 30 breaths, twice a day. During the initial two weeks, training sessions are supervised, and the device resistance is set between 30% and 50% of the participant's baseline Maximal Inspiratory Pressure (MIP). For the remaining six weeks (weeks 3 to 8), participants perform the exercises unsupervised at home, accompanied by weekly compliance checks. A key distinguishing feature of this protocol is the progressive overload design: MIP is re-evaluated at the beginning of the 3rd, 5th, and 7th weeks, and the device's resistance is systematically adjusted to 50% of the newly measured MIP to ensure continuous physiological adaptation.

    Also known as: IMT

06

What researchers measure

Primary outcomes

  1. Cognitive Function

    Cognitive Function Assessed by Montreal Cognitive Assessment (MoCA). The MoCA is a widely used screening tool for detecting cognitive impairment. Scores range from 0 to 30, with higher scores indicating better cognitive performance. A score of 26-30 is considered normal, 18-25 indicates mild cognitive impairment, 10-17 indicates moderate impairment, and 0-10 indicates severe cognitive impairment.

    Time frame: At baseline, and Week-8

  2. Maximal Inspiratory Pressure (MIP)

    MIP will be measured in cmH2O using a digital pressure meter (MD Diagnostics). Participants will perform maximum inspiratory maneuvers while seated upright with a nose clip. The highest value from three maneuvers (with less than 10% variability) will be recorded. Higher values indicate greater inspiratory muscle strength.

    Time frame: Baseline and Week 8

Secondary outcomes

  1. Maximal Expiratory Pressure (MEP)

    Maximal Expiratory Pressure(MEP) will be measured in cmH2O using a digital pressure meter. Participants will perform maximum expiratory maneuvers. The highest value from three maneuvers (with less than 10% variability) will be recorded. Higher values indicate greater expiratory muscle strength.

    Time frame: Baseline and Week 8

  2. Functional Capacity

    Functional Capacity Assessed by 6-Minute Walk Test (6MWT) Participants will be instructed to walk as fast as possible in a 30-meter straight corridor for 6 minutes. The test will be performed twice on the same day with a 30-minute rest interval, and the longer distance (in meters) will be recorded and used for analysis. Higher walking distances indicate better functional capacity.

    Time frame: Baseline and Week 8

  3. Lower Extremity Physical Performance Assessed by Short Physical Performance Battery (SPPB)

    Lower Extremity Physical Performance Assessed by Short Physical Performance Battery(SPPB) evaluates lower extremity function, mobility, and fall risk through three components: standing balance (side-by-side, semi-tandem, and tandem stances for 10 seconds), gait speed (4-meter walk test), and lower limb strength (5-times sit-to-stand test). The total SPPB score ranges from 0 to 12, with higher scores indicating better lower extremity physical performance and lower risk of mobility limitation and falls.

    Time frame: Baseline and Week 8

Other outcomes

  1. Comorbidity Burden Assessed by the Charlson Comorbidity Index (CCI)

    Comorbidity Burden Assessed by the Charlson Comorbidity Index (CCI) predicts the 10-year mortality risk by weighting the severity of comorbid conditions. CCI scores range from 0 to 37, with 0 indicating no comorbidity and higher scores indicating a greater burden of comorbid diseases and a higher predicted mortality risk. Scores of 1-2 indicate mild comorbidity, whereas scores of 3 or higher indicate a substantially increased mortality risk.

    Time frame: Baseline

07

Study locations

1 site
08

References and documents

Publications

  • Ozdilek B, Kenangil G. Validation of the Turkish Version of the Montreal Cognitive Assessment Scale (MoCA-TR) in patients with Parkinson's disease. Clin Neuropsychol. 2014;28(2):333-43. doi: 10.1080/13854046.2014.881554. Epub 2014 Feb 17. PubMed 24528299 ↗
  • Keskinoglu P, Ucku R, Yener G, Yaka E, Kurt P, Tunca Z. Reliability and validity of revised Turkish version of Mini Mental State Examination (rMMSE-T) in community-dwelling educated and uneducated elderly. Int J Geriatr Psychiatry. 2009 Nov;24(11):1242-50. doi: 10.1002/gps.2252. PubMed 19337986 ↗
  • Mello ESF, Oliveira ALMB, Santanna TDC, Soares PPDS, Rodrigues GD. Updates in inspiratory muscle training for older adults: A systematic review. Arch Gerontol Geriatr. 2024 Dec;127:105579. doi: 10.1016/j.archger.2024.105579. Epub 2024 Jul 15. PubMed 39032314 ↗
  • Colon-Emeric CS, McDermott CL, Lee DS, Berry SD. Risk Assessment and Prevention of Falls in Older Community-Dwelling Adults: A Review. JAMA. 2024 Apr 23;331(16):1397-1406. doi: 10.1001/jama.2024.1416. PubMed 38536167 ↗
  • Cebria i Iranzo Md, Arnall DA, Igual Camacho C, Tomas JM. Effects of inspiratory muscle training and yoga breathing exercises on respiratory muscle function in institutionalized frail older adults: a randomized controlled trial. J Geriatr Phys Ther. 2014 Apr-Jun;37(2):65-75. doi: 10.1519/JPT.0b013e31829938bb. PubMed 23835773 ↗

Individual participant data

Plan to share: No — Individual participant data (IPD) will not be shared because informed consent for secondary data sharing with third parties was not obtained from the participants, in accordance with the ethical approval.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it moved

Started Sep 2026 (actual). Primary completion is estimated for Mar 2027, 6 months after the start.

Since we started tracking on Sep 25, 2026, the dates moved once, on Nov 4, 2026: start Jul 2026 → Sep 2026, primary completion Nov 2026 → Mar 2027 and completion Jan 2027 → Apr 2027.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Jul 22, 2026
First posted
Jul 27, 2026
StartActual
Sep 1, 2026was Jul 2026
Primary completionEst.
Mar 20, 2027was Nov 2026
CompletionEst.
Apr 15, 2027was Jan 2027
Last update
Nov 4, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Sites
1 site added, 1 site removed
Show site
  • Acıbadem University · Istanbul, Turkey (Türkiye)
Show 1 removed
  • Acıbadem University · Istanbul, Turkey (Türkiye)
Nov 4, 2026
Start date
Jul 24, 2026→Sep 1, 2026 (actual)
Nov 4, 2026
Primary completion
Nov 20, 2026→Mar 20, 2027
Nov 4, 2026
Study completion
Jan 15, 2027→Apr 15, 2027
Nov 4, 2026
Show all 1 update
  1. Nov 4, 2026
    1 site added, 1 site removed
    Show site
    • Acıbadem University · Istanbul, Turkey (Türkiye)
    Show 1 removed
    • Acıbadem University · Istanbul, Turkey (Türkiye)
    Start date Jul 24, 2026→Sep 1, 2026 (now actual)
    Primary completion Nov 20, 2026→Mar 20, 2027
    Study completion Jan 15, 2027→Apr 15, 2027

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07728279
Responsible party
Ozge Hakli (Research Assistant, Acibadem University) — Principal investigator
First posted
Jul 27, 2026
Start date
Sep 1, 2026
Primary completion
Mar 20, 2027 (estimated)
Completion
Apr 15, 2027 (estimated)
Last update
Nov 4, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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