Abstract
Numerous animal studies have found that physical activity may modify brain pathology linked to the Alzheimeŕs disease (AD) pathophysiology, such as cortical amyloid deposition. Studies in humans have indicated that cognitive and behavioural symptoms of AD may also be ameliorated by exercise interventions. This effect may be mediated by an effect on aforementioned AD pathology. Therefore, we undertook a systematic review of randomised trials examining the effects of physical exercise on validated AD biomarkers. Studies eligible for inclusion were intervention studies of physical exercise with 1 or more of the following AD biomarkers as outcome measures: a) Aβ1–42, Total-tau and/or Phosphorylated-tau in cerebrospinal fluid; b) 18F-FDG-PET imaging, c) amyloid-PET imaging or d) hippocampal volume measured on MRI. Participants could be healthy subjects, patients with MCI or AD dementia. Studies had to be published from January 1984 to November 2016 in English. Search words were identified and refined by identifying key concepts and words in relevant publications together with the use of controlled vocabularies and thesauruses such as Medical Subject Headings. Databases searched were: MEDLINE, EMBASE, Cochrane Register of Controlled Clinical Trials, PsycInfo and Web of Science. 54205 citations were identified. Of these 7 papers were included, containing 508 participants (252 in intervention group, 256 in control group) (figure 1). One study included AD patients and the rest healthy subjects. Outcome measure was change in hippocampal volume on MRI (healthy subjects) and AD biomarkers in CSF (AD patients). Two studies reported an effect of aerobic exercise on hippocampal volume. One study found an absolute increase in the volume of the anterior hippocampus, which was significant compared to the control group. Another study found a detrimental effect of aerobic exercise in CA2/3 and dentate gyrus/CA4 subregions relative to the control group. There was no effect of the exercise intervention on AD CSF biomarkers.
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