Aerobic exercise and vascular cognitive impairment
A randomized controlled trial
Abstract
Objective:
To assess the efficacy of a progressive aerobic exercise training program on cognitive and everyday function among adults with mild subcortical ischemic vascular cognitive impairment (SIVCI).
Methods:
This was a proof-of-concept single-blind randomized controlled trial comparing 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 aerobic exercise training. Primary outcomes assessed were 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]).
Results:
Seventy adults randomized to aerobic exercise training or usual care were included in intention-to-treat analyses (mean age 74 years, 51% female, n = 35 per group). At the end of the intervention, the aerobic exercise training group had significantly improved ADAS-Cog performance compared with the usual care plus education group (−1.71 point difference, 95% confidence interval [CI] −3.15 to −0.26, p = 0.02); however, this difference was not significant at the 6-month follow-up (−0.63 point difference, 95% CI −2.34 to 1.07, p = 0.46). There were 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, 95% CI 5.82 to 54.86, p = 0.02) and in diastolic blood pressure (−6.89 mm Hg difference, 95% CI −12.52 to −1.26, p = 0.02).
Conclusions:
This study provides preliminary evidence for the efficacy of 6 months of thrice-weekly progressive aerobic training in community-dwelling adults with mild SIVCI, relative to usual care plus education.
ClinicalTrials.gov identifier:
NCT01027858.
Classification of evidence:
This study provides Class II evidence that for adults with mild SIVCI, an aerobic exercise program for 6 months results in a small, significant improvement in ADAS-Cog performance.
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Supplementary Material
AUTHOR AFFILIATION
From the Department of Physical Therapy (T.L.-A., J.R.B., J.C.D., J.J.E., L.A.B.), Division of Geriatric Medicine (P.E.L.), and Division of Neurology (C.J., G.-Y.R.H.), University of British Columbia; Djavad Mowafaghian Centre for Brain Health (T.L.-A., J.R.B., J.C.D., L.A.B., G.-Y.R.H.), Centre for Hip Health and Mobility (T.L.-A., J.R.B., J.C.D., M.M., W.C.), and Centre for Clinical Epidemiology and Evaluation (P.M.B.), Vancouver Coastal Health Research Institute; and University of British Columbia Hospital Clinic for Alzheimer Disease and Related Disorders (P.E.L., C.J., G.-Y.R.H.), Vancouver, Canada.
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Information & Authors
Information
Published In
Copyright
© 2016 American Academy of Neurology.
Publication History
Received: February 9, 2016
Accepted: July 5, 2016
Published online: October 19, 2016
Published in issue: November 15, 2016
Disclosure
The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.
Study Funding
Canadian Stroke Network and the Heart and Stroke Foundation of Canada. The funding source had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.
Authors
Author Contributions
Dr. Liu-Ambrose had full access to the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: T.L.-A., J.R.B., J.C.D., J.J.E., P.E.L., C.J., L.A.B., P.M.B., M.M., W.C., G.-Y.R.H. Acquisition, analysis, or interpretation of data: T.L.-A., J.R.B., J.C.D., J.J.E., P.M.B., M.M., W.C., G.-Y.R.H. Drafting of the manuscript: T.L.-A., J.R.B., J.C.D. Critical revision of the manuscript for important intellectual content: T.L.-A., J.R.B., J.C.D., J.J.E., P.E.L., C.J., L.A.B., P.M.B., M.M., W.C., G.-Y.R.H. Statistical analysis: T.L.-A., J.R.B., J.C.D., P.M.B. Obtained funding: T.L.-A., J.J.E., L.A.B., C.J., P.M.B., G.-Y.R.H. Administrative, technical, or material support: T.L.-A., J.C.D., G.-Y.R.H., P.E.L., M.M., W.C. Study supervision: T.L.-A., G.-Y.R.H.
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- Glutathione Peroxidase Activity Is Altered in Vascular Cognitive Impairment-No Dementia and Is a Potential Marker for Verbal Memory Performance, Journal of Alzheimer’s Disease, 79, 3, (1285-1296), (2025).https://doi.org/10.3233/JAD-200754
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- Does Sleep Moderate the Effects of Exercise Training or Complex Mental and Social Activities on Cognitive Function in Adults With Chronic Stroke? Secondary Analysis of a Randomized Trial, The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 80, 1, (2024).https://doi.org/10.1093/gerona/glae264
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