Exercise counters the negative impact of bed rest on executive functions in middle-aged and older adults: A proof-of-concept randomized controlled trial

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ObjectivesProlonged bed rest is prevalent among middle-aged and older adults and is associated with multiple negative health outcomes. Therefore, it is important that we better understand the utility of exercise training as a countermeasure to the adverse effects of bed rest. We examined the effect of exercise training on intraindividual variability in cognitive performance among adults aged 55–65 exposed to 14 days of physical inactivity modelled via 6° head-down tilt bed rest. MethodsThe study is a non-blinded, parallel-group, proof-of-concept randomized controlled trial. Twenty-three healthy middle-aged and older adults (12 males, 11 females) aged 55–65 were randomized to: (1) 14 days of 6° head-down tilt bed rest (Control) or (2) 14 days of 6° head-down tilt bed rest with daily exercise (Exercise). The National Institutes of Health Toolbox Cognitive Battery assessed executive functions (Flanker incongruent/congruent and Dimensional Change Card Sort) and processing speed (Pattern Comparison). We assessed cognitive function at baseline, 6° head-down tilt bed rest midpoint, completion, and seven days following completion. We indexed intraindividual variability with two metrics: (1) residual intraindividual standard deviation and (2) intraindividual coefficient of variation. Flanker congruent and incongruent residual intraindividual standard deviations were the primary outcomes. Linear mixed models assessed between-group differences and the moderating effect of biological sex. ResultsAt bed rest completion, Exercise had significantly lower (better) Flanker incongruent residual intraindividual standard deviation (estimated mean difference = −3.63, 95%CI -6.10;-1.17, p = 0.005) and intraindividual coefficient of variation (estimated mean difference = −0.10, 95%CI -0.19;-0.003, p = 0.022) vs. Control. Sex moderated the effect of exercise on Flanker incongruent intraindividual coefficient of variation. Exercise females had significantly lower intraindividual coefficient of variation vs. Control (estimated mean difference = −0.23; 95%CI -0.34;-0.12, p < 0.001). There were no significant between-group differences in processing speed intraindividual variability and summary scores of executive functions and processing speed (ps > 0.05). ConclusionExercise training during bed rest preserved intraindividual variability of executive functions but not processing speed. Trial registrationClinicalTrials.gov NCT04964999