OBJECTIVE: This study aims to investigate the effects of exercise-cognitive dual-task training on frailty status, cognitive function, physical performance, and dual-task cognitive load in older adults with Cognitive frailty (CF) over a 16-week intervention period. METHODS: This randomized controlled trial enrolled older adults with CF at community health service center in Chaoyang District, Beijing, between February and March 2024. Participants were randomly assigned to either the dual-task training group or the health education group in a 1:1 ratio. The dual-task training group received an exercise-cognitive dual-task training program, while the health education group received information on CF, including its symptoms, risk factors, and non-pharmacological prevention and treatment strategies. The primary outcomes were frailty status, while the secondary outcomes included cognitive function, balance and gait function, walking ability, and dual-task cognitive load. RESULTS: A total of 72 participants (35 males) were enrolled, including 36 individuals (mean age 74.81 +/- 8.23years, 17 males, mean BMI: 21.38 +/- 2.83kg/m2) in the dual-task training group, and 36 individuals (mean age 76.50 +/- 7.75years, 18 males, mean BMI: 22.18 +/- 2.12kg/m2) in the health education group. Participants (n = 72) were 75.66 +/- 7.9 years old; 48.6% (35/72) were male and 51.4% (37/72) were female. Following the intervention, the dual-task training group exhibited significant improvements compared to the health education group in the Tilburg Frailty Index (5.14 +/- 0.99 versus 7.36 +/- 1.07, p < 0.001) and Montreal Cognitive Assessment scores (27.25 +/- 2.41 versus 23.47 +/- 1.87, p < 0.001). Additionally, the dual-task training group demonstrated superior outcomes in the Performance-Oriented Mobility Assessment (POMA) scores (24.64 +/- 5.50 versus 17.39 +/- 4.38, p < 0.001), Time Up and Go Test (TUGT) indicators (10.66 +/- 1.76 versus 12.01 +/- 2.21, p < 0.05), and cognitive load measures (all p < 0.05). CONCLUSION: Exercise-cognitive dual-task training may effectively improve frailty status, cognitive function, physical performance, and dual-task cognitive load in older adults with CF, suggesting its potential for broader application in this population. CLINICAL TRIAL REGISTRATION: http://www.chictr.org.cn/, ChiCTR2400080105.

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