Abstract

We aimed to evaluate the effect of multi-ingredient nutritional supplementation, with and without exercise training, on cognitive function in healthy older men. Forty-nine sedentary men [age: 73 ± 6 years (mean ± SD); body mass index: 28.5 ± 3.6 kg/m2] were randomized to consume a supplement (SUPP n = 25; 1500 mg n-3 polyunsaturated fatty acids, 30 g whey protein, 2.5 g creatine, 500 IU vitamin D, and 400 mg calcium) or control beverage (CON n = 24; 22 g maltodextrin) twice daily for 20 weeks consisting of Phase 1: SUPP/CON followed by Phase 2: 12-week resistance exercise training plus high-intensity interval training, while continuing to consume the study beverages (SUPP/CON + EX). At baseline, 6 weeks, and 19 weeks we assessed cognitive function [Montréal Cognitive Assessment (MOCA)], memory [word recall during the Rey Auditory Verbal Learning Test (RAVLT)], executive functions (working memory inhibition control), and nutrient bioavailability. We did not observe changes to any aspect of cognitive function after Phase 1; however, significant improvements in the following cognitive function outcomes were detected following Phase 2: MOCA scores increased (6 weeks: 23.5 ± 3.3 vs. 19 weeks: 24.4 ± 2.5, p = 0.013); number of words recalled during the RAVLT increased (6 weeks: 6.6 ± 3.6 vs. 19 weeks: 7.6 ± 3.8, p = 0.047); and reaction time improved (6 weeks: 567 ± 49 ms vs. 19 weeks: 551 ± 51 ms, p = 0.002). Although between-group differences in these outcomes were not significant, we observed within-group improvements in composite cognitive function scores over the course of the entire study only in the SUPP group (Δ = 0.58 ± 0.62, p = 0.004) but not in the CON group (Δ = 0.31 ± 0.61, p = 0.06). We observed a progressive increase in n-3 index, and a concomitant decrease in the ratio of arachidonic acid (ARA) to eicosapentaenoic acid (EPA) within erythrocyte plasma membranes, in the SUPP group only. At week 19, n-3 index (r = 0.49, p = 0.02) and the ARA:EPA ratio (r = -0.44, p = 0.03) were significantly correlated with composite cognitive function scores. Our results show that 12 weeks of RET + HIIT resulted in improved MOCA scores, word recall, and reaction time during an executive functions task; and suggest that a multi-ingredient supplement combined with this exercise training program may improve composite cognitive function scores in older men possibly via supplementation-mediated alterations to n-3 PUFA bioavailability.Clinical Trial Registration: http://www.ClinicalTrials.gov, identifier NCT02281331.

Highlights

  • Dementia is an incurable and debilitating neurodegenerative disorder that severely impairs cognitive function

  • We propose that combining multiple nutritional supplement with an exercise training program that includes both resistance exercise training (RET) and high-intensity interval training (HIIT) components may lead to greater improvements in cognitive function compared to each nutrient or intervention alone (Dziedzic, 2006; Franceschi et al, 2007; Peake et al, 2010)

  • Upon completion of the exercise training program, higher bioavailability of n−3 polyunsaturated fatty acids (PUFA) was associated with greater overall cognitive abilities

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Summary

Introduction

Dementia is an incurable and debilitating neurodegenerative disorder that severely impairs cognitive function. Dementia affects approximately 50 million people worldwide, this number is expected to reach 75 million by the year 2030 (Prince et al, 2015). The impact of this cognitive impairment is widespread and includes reductions in the ability of affected persons to perform activities of daily living, and increases in the financial and psychological burden on families and caregivers (Alzheimer Society of Canada, 2010). Shorter term (12–24 weeks) exercise training interventions have been shown to improve aspects of cognitive function in older adults, such as executive functions, memory, and processing speed (Smith et al, 2010). Improvements in cognitive function may be enhanced when aerobic and resistance exercise are combined (Colcombe and Kramer, 2003)

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