Abstract
BackgroundTo examine the effect of multicomponent exercise program on memory function in older adults with mild cognitive impairment (MCI), and identify biomarkers associated with improvement of cognitive functions.Methodology/Principal FindingsSubjects were 100 older adults (mean age, 75 years) with MCI. The subjects were classified to an amnestic MCI group (n = 50) with neuroimaging measures, and other MCI group (n = 50) before the randomization. Subjects in each group were randomized to either a multicomponent exercise or an education control group using a ratio of 1∶1. The exercise group exercised for 90 min/d, 2 d/wk, 40 times for 6 months. The exercise program was conducted under multitask conditions to stimulate attention and memory. The control group attended two education classes. A repeated-measures ANOVA revealed that no group × time interactions on the cognitive tests and brain atrophy in MCI patients. A sub-analysis of amnestic MCI patients for group × time interactions revealed that the exercise group exhibited significantly better Mini-Mental State Examination (p = .04) and logical memory scores (p = .04), and reducing whole brain cortical atrophy (p<.05) compared to the control group. Low total cholesterol levels before the intervention were associated with an improvement of logical memory scores (p<.05), and a higher level of brain-derived neurotrophic factor was significantly related to improved ADAS-cog scores (p<.05).Conclusions/SignificanceThe results suggested that an exercise intervention is beneficial for improving logical memory and maintaining general cognitive function and reducing whole brain cortical atrophy in older adults with amnestic MCI. Low total cholesterol and higher brain-derived neurotrophic factor may predict improvement of cognitive functions in older adults with MCI. Further studies are required to determine the positive effects of exercise on cognitive function in older adults with MCI.Trial RegistrationUMIN-CTR UMIN000003662 ctr.cgi?function = brows&action = brows&type = summary&recptno = R000004436&language = J.
Highlights
Alzheimer’s disease (AD) places a considerable and increasing burden on patients, caregivers and society
The multicomponent exercise program included aerobic exercise, muscle strength training, and postural balance retraining, because previous reviews suggested that combined aerobic exercise and strength training interventions improved attention and working memory to a greater extent than aerobic exercise alone. [11,18] We explored the biomarkers for identifying improvement of cognitive functions
Previous studies reported that aerobic exercise or other physical activity can increase executive function in older adults with cognitive impairments, but the effects of exercise on memory function in this population remain unclear. [4,5,6,7,8] To our knowledge, this is the first study to demonstrate an improvement in logical memory following multicomponent exercise training among older adults with amnestic MCI group (aMCI)
Summary
Alzheimer’s disease (AD) places a considerable and increasing burden on patients, caregivers and society. [4,5,6,7,8] Several meta-analyses have reported that physical activity is associated with improvements in attention, processing speed, and executive function in older adults with and without cognitive impairments. [12] For example, a population-based study in Sweden reported that the relative risks of progression to dementia in a 3-year follow-up in subjects with mild, moderate, and severe cognitive impairment (without dementia), were 3.6, 5.4, and 7.0, respectively. [4,5,6,7,8] These studies have revealed the effects of exercise or physical activity on cognitive function, including executive function, in older adults with MCI. To examine the effect of multicomponent exercise program on memory function in older adults with mild cognitive impairment (MCI), and identify biomarkers associated with improvement of cognitive functions
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