Exercise Slows Brain Aging in Patients With Mild Cognitive Impairment

Both low and moderate-high intensity exercise could be effective strategies in the battle against Alzheimer's disease, suggested researchers at the University of California, San Diego and Wake Forest University (1^✔ ✔Trusted Source
Effects of exercise on cognition and Alzheimer's biomarkers in a randomized controlled trial of adults with mild cognitive impairment: The EXERT study

Go to source). The new study, published as two papers in Alzheimer's and Dementia: The Journal of the Alzheimer's Association, describes the findings of the EXERT study (Exercise in Adults with Mild Memory Problems), a multi-site clinical trial of lower or moderate-high intensity exercise in sedentary older adults with amnestic mild cognitive impairment, a major risk factor for Alzheimer's dementia. The researchers also compared their findings to an existing dataset of similar individuals who simply received standard treatment, such as regular check-ups with doctors and medication management.

Exercise Slows Cognitive Decline and Brain Volume Loss

The findings of the EXERT study:

• Cognitive function in EXERT participants was steady after 12 months in both the low and moderate-high intensity exercise groups.
• Both types of exercise were associated with significantly less cognitive impairment over 12 months as compared to those who did not participate in the exercise research.
• Both EXERT exercise groups lost less brain volume after 12 months, including in the prefrontal cortex.
• Individuals with amnestic mild cognitive impairment, a disease defined by memory complaints and objective memory decline, are at high risk of developing Alzheimer's dementia, with around 16% of those diagnosed progressing to Alzheimer's every year.

"This is a critical time to intervene in this population because they do not yet have dementia but are at a very high risk," said Aladdin Shadyab, Ph.D., M.P.H., lead author of one of the new papers and associate professor at the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science and School of Medicine. "Together, these findings show us that even low intensity exercise may slow cognitive decline in at-risk older adults."

Exercise Boosts Cognitive Health

While earlier research has suggested that exercise may help cognitive health, the data is conflicting, and large, well-designed trials are required to fully evaluate the potential advantages of exercise for older persons with mild cognitive impairment. The EXERT trial, led by the Alzheimer's Disease Cooperative trial (ADCS) at UC San Diego in collaboration with Wake Forest University School of Medicine, covers this void.

"EXERT was one of the first large clinical trials of exercise that partnered with the YMCA and its trainers to bring the intervention closer to home for research participants," said Howard Feldman, M.D., director of ADCS. "This approach brings us one step closer to its implementation in the community."

The ADCS was established in 1991 through a cooperation agreement between the National Institute on Aging and UC San Diego, and it is one of the primary federally funded Alzheimer's research programs, focusing on therapies for both cognitive and behavioral symptoms of Alzheimer's.

Preventing and Treating Alzheimer's Dementia

"There's an urgent need to identify effective and feasible ways to prevent and treat Alzheimer's dementia, and UC San Diego has been a leader in this field for many years," said Feldman, a professor in the Department of Neurosciences at the UC San Diego School of Medicine.

EXERT involved approximately 300 sedentary older individuals with mild cognitive impairment who were randomly randomized to either moderate-high intensity aerobic training or lower-intensity stretching, balance, and range of motion activities. Participants conducted their allocated workout 3-4 times per week for 12 months while being supervised by a YMCA trainer. The study also included regular examinations of cognitive function and brain volume.

"EXERT is a landmark study because it's the largest rigorous trial of exercise ever conducted in adults with mild cognitive impairment," said Laura Baker, Ph.D., the study's principal investigator and a professor of gerontology and geriatric medicine at Wake Forest University School of Medicine.

"Exercise has well-documented advantages for practically every area of human health, but we are still exploring its full potential as a treatment for older persons with memory issues.

Though the researchers expected to detect additional cognitive impairment in EXERT participants, they discovered that cognitive function remained consistent across both exercise groups throughout the trial. This implies that both low and high-intensity exercise may delay cognitive deterioration. Another possible explanation for the findings is that participation in research, independent of treatment, may provide protection against cognitive deterioration due to the intellectual and social stimulation.

Overall, the outcomes of both studies indicate that exercise may be a beneficial, safe, and realistic method for promoting brain health and preventing further cognitive loss in older persons with mild cognitive impairment.

"While there's still a lot to learn, these findings show that regular intensity exercise, even at low intensity, could go a long way toward helping older adults slow or delay cognitive decline, and this is promising news for those who are at high risk for dementia," according to Shadyab.

Reference:

1. Effects of exercise on cognition and Alzheimer's biomarkers in a randomized controlled trial of adults with mild cognitive impairment: The EXERT study - (https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.14586)

Source-Medindia