## 4 Discussion
### Cognitive Function  
Cognitive function was also improved significantly in both groups, which supports the view that multiparameter exercise, and not solely aerobic exercise, programs improve cognitive function [73]. Other studies examining the effectiveness of the Otago program in cognitive function using the MoCA scale also yielded cognitive improvements [74; 75]. Additionally, our results are in line with the research of studies suggesting a high correlation between regular physical exercise and memory improvement, the efficiency of attentional and executive-control processes, object naming, orientation, and arithmetic function [76; 77; 78]. The analysis of our results showed that the time of delivery of the visual/verbal orders did not have a significant effect on the cognitive function between the two groups. It is noteworthy, however, that the cognitive function showed greater (although not statistically significant) improvement in the advance guidance group compared to balance, gait, and fear of falling variables, which were revealed to be slightly more improved in the parallel guidance group. The above observation raises additional questions as to whether the demonstration and explanation of the exercise before the execution and the correction during the execution ultimately improves cognitive function. Individual learning patterns and preferences may play a role in the above results. Depending on the neural circuits engaged during skill acquisition and/or the motor learning phase (cognitive, associative, and autonomous) within which an individual is [79], people may prefer different learning styles. Some individuals may prefer to receive instructions before the task, allowing them to familiarize themselves with the routine and plan their activities. In this case, the frontal and parietal areas are overactive because of the high attentional request, while in case of others who find it more effective to have guidance accessible during the exercise session, the cortical and subcortical motor areas are more activated due to a lessened reliance on attention-executive networks [80]. While motor performance improvements depend on both cortical and subcortical regions, to our knowledge, no studies have been conducted to examine the provision of feedback before and during exercise on cognitive function. However, the feedback element has been extensively studied for its importance in the learning process [81; 82; 83]. Indeed, positive feedback has the advantage of eliciting interest and enjoyment during the task and promoting self-efficacy [83; 84]. These emotional states influence cognitive functions through plastic changes in prefrontal areas and limbic structures [85; 86] and are fundamental components for motor control and motor learning [87]. The cognitive function concerns attention, awareness, and reasoning, elements on which the feedback of the advance guidance way of delivering the Otago program focuses [14]. Demonstrating and explaining the importance of the exercise before its implementation are elements that require the attention and awareness of the participant [79]. Performance correction engages the participant in a reasoning process to develop the best strategy and make them aware of the characteristics of the exercise. Additionally, by observing a task which they are later asked to reproduce, the performer is engaged to memorize a task, to decide the sequence and steps to follow in order to reproduce the task, and to solve new and different motor problems as they arise, rather than just being provided with the solution [34]. This enhances the process of learning and therefore the cognitive function of the elderly [88]. One would expect that, since the advance guidance group performed better in the cognitive test, they would have better balance and gait performance. This did not happen. However, the differences between the groups were not significant, in order to proceed with such an interpretation.