Physical Exercise May Increase Plasma Concentration of High-Density Lipoprotein-Cholesterol in Patients With Alzheimer's Disease.

Camilla Steen Jensen,Birgitte Bo Andersen,Peter Høgh,Hanne Gottrup,Karsten Vestergaard,Ruth Frikke-Schmidt,Anja Hviid Simonsen,Nina Beyer,Steen Hasselbalch,Gunhild Waldemar,Kristian Steen Frederiksen,Lene Wermuth,Christian Sandøe Musaeus

doi:10.3389/fnins.2020.00532

Abstract

Lifestyle factors have been shown to increase the risk of developing Alzheimer’s disease (AD) later in life. Specifically, an unfavorable cholesterol profile, and insulin resistance are associated with increased risk of developing AD. One way to non-pharmacologically affect the levels of plasma lipids is by exercise, which has been shown to be beneficial in cognitively healthy individuals. In this randomized controlled trial y, we therefore aimed to clarify the effect of physical exercise on the lipid profile, insulin and glucose in patients with AD. In addition, we investigated the effect of apolipoproteinE genotype on total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein–cholesterol (LDL-C), and triglycerides (TG) in plasma from patients with AD. Plasma samples from 172 patients who underwent 16 weeks of moderate-to-high intensity exercise (n = 90) or treatment as usual (n = 82) were analyzed change from baseline for the levels of total cholesterol, LDL-C, HDL-C, TG, glucose, and insulin. In addition, we analyzed those from the exercise group who adhered to the protocol with an attendance of 2/3 or more of the exercise session and who followed the protocol of an intensity of 70% of the maximum heart rate. We found a significant increase in plasma HDL-C levels between the “high exercise sub-group” compared to control group. After intervention HDL-C was increased by 4.3% in the high-exercise group, and decreased by 0.7% in the control group, after adjustment for statin use. In conclusion, short term physical activity may be beneficial on the cholesterol profile in patients with AD.

Highlights

Lifestyle risk factors in midlife are associated with risk of developing Alzheimer’s disease (AD) later in life (Kivipelto et al, 2001; Pope et al, 2003; Biessels et al, 2006)
We aimed to explore the effect of physical exercise on the lipid profile, levels of insulin and glucose, and the effect of APOE genotype on cholesterol metabolism in plasma from patients with AD
We investigated the effect of 16 weeks of moderate-to-high intensity physical exercise on the plasma levels of lipids, glucose, and insulin in patients with AD

Summary

Introduction

Lifestyle risk factors in midlife are associated with risk of developing Alzheimer’s disease (AD) later in life (Kivipelto et al, 2001; Pope et al, 2003; Biessels et al, 2006). An adverse lipid profile, and insulin resistance have been associated with increased risk of developing AD. The exact role of lipids and lipoproteins for development of AD or AD pathology is, unknown (Anstey et al, 2017). Previous studies are conflicting and show both increases and decreases risk associated with high levels of total cholesterol. In late-life, TC was not associated with cognitive or dementia outcomes in any analyses or in any of the large individual studies that were not compatible for pooling (Anstey et al, 2017). High-density lipoprotein-cholesterol (HDL-C) levels in aging individuals have been associated with better cognition. Modifications of the lipid profile e.g., decreasing total cholesterol and low-density lipoprotein– cholesterol (LDL-C) and increasing HDL-C concentrations might benefit patients with AD

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