Exercise Training in Amnestic Mild Cognitive Impairment: A One-Year Randomized Controlled Trial

Takashi Tarumi, Heidi Rossetti, Binu P. Thomas, Thomas Harris, Benjamin Y. Tseng, Marcel Turner, Ciwen Wang, Zohre German, Kristin Martin-Cook, Ann M. Stowe, Kyle B. Womack, Dana Mathews, Diana R. Kerwin, Linda Hynan, Ramon Diaz-Arrastia, Hanzhang Lu, C. Munro Cullum, Rong Zhang, Ozioma Okonkwo

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

Background: The current evidence is inconclusive to support the benefits of aerobic exercise training (AET) for preventing neurocognitive decline in patients with amnestic mild cognitive impairment (aMCI). Objective: To examine the effect of a progressive, moderate-to-high intensity AET program on memory and executive function, brain volume, and cortical amyloid-β (Aβ) plaque deposition in aMCI patients. Methods: This is a proof-of-concept trial that randomized 70 aMCI patients to 12 months of AET or stretching and toning (SAT, active control) interventions. Primary neuropsychological outcomes were assessed by using the California Verbal Learning Test-second edition (CVLT-II) and the Delis-Kaplan Executive Function System (D-KEFS). Secondary outcomes were the global and hippocampal brain volumes and the mean cortical and precuneus Aβ deposition. Results: Baseline cognitive scores were similar between the groups. Memory and executive function performance improved over time but did not differ between the AET and SAT groups. Brain volume decreased and precuneus Aβ plaque deposition increased over time but did not differ between the groups. Cardiorespiratory fitness was significantly improved in the AET compared with SAT group. In amyloid positive patients, AET was associated with reduced hippocampal atrophy when compared with the SAT group. Conclusion: The AET and SAT groups both showed evidence of slightly improved neuropsychological scores in previously sedentary aMCI patients. However, these interventions did not prevent brain atrophy or increases in cortical Aβ deposition over 12 months. In amyloid positive patients, AET reduced hippocampal atrophy when compared with the SAT group.

Original languageEnglish
Pages (from-to)421-433
Number of pages13
JournalJournal of Alzheimer's Disease
Volume71
Issue number2
DOIs
StatePublished - 2019

Bibliographical note

Funding Information:
Despite these limitations, participation in AET or SAT program was associated with improved performance on memory and executive function tests in previously sedentary aMCI patients, although these changes were small and the interventions did not prevent progression of brain atrophy and Aβ deposition. Peak VO2 significantly increased in the AET group, reflecting improved cardiovascular health. In amyloid positive patients, hippocampal atrophy was attenuated by AET. Collectively, these findings suggest benefits of both AET and SAT exercise on neuropsychological function in aMCI patients. Further studies We thank each of the study participants for their effort and time contributing to the study. This work was funded by the National Institutes of Health (R01AG033106, R01HL102457, P30AG012300, and K99HL133449). The18F-florbetapir PET radiotracer was provided to the study by Avid Radiopharmaceuticals. Authors’ disclosures available online (https:// www.j-alz.com/manuscript-disclosures/18-1175r2).

Publisher Copyright:
© 2019 - IOS Press and the authors. All rights reserved.

Keywords

  • Aerobic exercise
  • amyloid deposition
  • brain volume
  • cardiovascular fitness
  • mild cognitive impairment

ASJC Scopus subject areas

  • Neuroscience (all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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