Aerobic Exercise Significantly Improves Cognitive Function in Older Adults

Aerobic exercise 3 times a week significantly improved cognitive function in older adults with cognitive impairment due to disease of the small blood vessels of the brain—the most common form of vascular cognitive impairment (VCI)—according to a new study. After Alzheimer disease, VCI is the second most common cause of dementia.

“Given the well-established benefits of exercise and that few treatment options are available for VCI, our study suggests that exercise should be recommended in the management of individuals with VCI,” said study lead author Teresa Liu-Ambrose, PT, PhD, from the Department of Physical Therapy at the University of British Columbia in Vancouver, Canada.
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This proof-of-concept, single-blind, randomized, controlled trial compared a 6-month, thrice-weekly, progressive aerobic exercise training program (AT) with usual care plus education on cognitive and everyday function, with a follow-up assessment 6 months after the formal cessation of AT. Primary outcomes assessed included general cognitive function (Alzheimer’s Disease Assessment Scale–Cognitive subscale [ADAS-Cog]), executive functions (Executive Interview [EXIT-25]), and activities of daily living (Alzheimer’s Disease Cooperative Study–Activities of Daily Living [ADCS-ADL]).

The researchers included 70 adults randomized to AT or usual care in intention-to-treat analyses (mean age 74 years, 51% female). At the end of the intervention, the AT group had significantly improved ADAS-Cog performance compared with the usual care plus education group; however, this difference was not significant at the 6-month follow-up. They found no significant between-group differences at intervention completion and at the 6-month follow-up in EXIT-25 or ADCS-ADL performance. Examination of secondary measures showed between-group differences at intervention completion favoring the AT group in 6-minute walk distance (30.35-meter difference) and in diastolic blood pressure (-6.89 mm Hg difference).

“We also found that despite multiple preexisting chronic conditions, most participants were able to progress from light to moderate intense aerobic exercise and enjoyed it, as indicated by the minimal dropout in the aerobic group,” Dr Liu-Ambrose said.

The researchers are conducting a new study with a larger sample size and embedding additional outcomes to better understand underlying mechanisms, she said.

—Mike Bederka

Reference:

Liu-Ambrose T, Best JR, Davis JC, et al. Aerobic exercise and vascular cognitive impairment: a randomized controlled trial [published online October 19, 2016]. Neurology. doi:10.1212/WNL.0000000000003332.