背景：雙重任務訓練 (dual task training) 可以結合運動任務及認知任務，是有效改善社區長輩認知功能的方法。依認知任務目的，可分為外加型雙重任務與合併型雙重任務。目前少有研究同時比較外加型雙重任務與合併型雙重任務訓練在認知功能的成效。因此，本研究目的為比較合併型與外加型的雙重任務訓練在社區長輩的認知功能、身體功能、日常生活功能、雙重任務表現以及憂鬱的成效。

方法：本研究招募3個社區長輩以據點為單位，隨機分派為雙重任務訓練「合併型組」與「外加型組」。所有受試者皆接受每周1次，每次2小時，共12周的介入。受試者皆會在前測 (T0)、後測 (T1) 及追蹤 (T2) 評估。主要成效評估為認知功能，含：蒙特利爾認知評估量表、路徑描繪測驗、語言流暢性、順序與逆序數字測驗、字詞測驗、史處普色字測驗、數字符號替代測驗。次要成效評估包含：身體功能、日常生活功能、雙重任務表現與憂鬱。本研究將使用t檢定與共變數分析 (ANCOVA) 檢測「合併型組」與「外加型組」的在前測 (T0) 與後測 (T1) 以及前測 (T0) 與追蹤 (T2) 的改變分數差異。

結果：前測中，語言流暢性、史處普測驗的色字不同分測驗（秒）與錯誤數、起身行走測驗、社區整合問卷、箱與積木測驗純丟積木的積木個數、箱與積木加算術的積木個數、箱與積木測驗加聲音反應的反應正確數與反應錯誤數有顯著差異，且「外加型組」皆優於「合併型組」。前測與後測分數改變量中，「外加型組」(n = 20) 比「合併型組」(n=16) 在語言流暢性 (F=4.374; p=.044)、順序與逆序測驗總分 (t=2.106; p=.043)與順序分測驗 (t=2.208; p=.034)、史處普測驗的色字不同分測驗（秒）(F=14.415; p=.040)、數字符號替代測驗 (t=2.159; p=.038)、箱與積木加算術的計算錯誤數 (t=-2.898; p=.007) 有較佳的訓練成效；「合併型組」比「外加型組」在字詞測驗的清單B立即回想 (t=-2.415; p=.021) 有較佳的訓練成效。前測與追蹤分數改變量中，「外加型組」比「合併型組」在語言流暢性 (F=4.326; p=.048)、史處普測驗的色字不同分測驗（秒）(F=8.014; p=.008)。「合併型組」比「外加型組」在蒙特利爾認知評估量表 (t=-2.237; p=.032) 有較佳的訓練成效。

結論：社區長輩執行合併型雙重任務訓練或是外加型雙重任務訓練皆可以獲得認知益處。合併型雙重任務訓練較能改善以及維持整體認知功能；外加型雙重任務訓練較能改善特定的認知技巧。

Background: Dual task training may combine physical and cognitive tasks and is an effective way to improve cognitive function in community older adults. This study was a cluster randomized trial. Methods: Three community centers were randomly assigned to one of the two groups: incorporated dual task group or additional dual task group. All participants underwent training for 2 hours per session, one session a week for 12 weeks. The participants were assessed at baseline (T0), after the intervention (T1), and 12-week follow-up (T2). Result: At baseline (T0), the additional dual task group (n=20) had better performance than the incorporated dual task group (n=16) at 8 tests. In the difference between T0 and T1, the additional dual task group improved more than the incorporated dual task group at 6 tests. In contrast, the incorporated dual task group improved more than the additional dual task group at 1 test. In the difference between T0 and T2, the additional dual task group improved more than the incorporated dual task group at 2 tests. In contrast, the incorporated dual task group improved more than the additional dual task group at 1 test. Conclusion: Community older adults improved their cognitive function after participating in the incorporated or additional dual task training. Incorporated dual task training is beneficial to overall cognitive functions. Additional dual task training is beneficial to specific cognitive abilities.

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