Abstract
BackgroundPhysical activity exerts a variety of long-term health benefits in older adults. In particular, it is assumed to be a protective factor against cognitive decline and dementia.Methods/designRandomised controlled assessor blinded 2-armed trial (n = 60) to explore the exercise- induced neuroprotective and metabolic effects on the brain in cognitively healthy older adults. Participants (age ≥ 65), recruited within the setting of assisted living facilities and newspaper advertisements are allocated to a 12-week individualised aerobic exercise programme intervention or a 12-week waiting control group. Total follow-up is 24 weeks. The main outcome is the change in cerebral metabolism as assessed with Magnetic Resonance Spectroscopic Imaging reflecting changes of cerebral N-acetyl-aspartate and of markers of neuronal energy reserve. Imaging also measures changes in cortical grey matter volume. Secondary outcomes include a broad range of psychometric (cognition) and movement-related parameters such as nutrition, history of physical activity, history of pain and functional diagnostics. Participants are allocated to either the intervention or control group using a computer-generated randomisation sequence. The exercise physiologist in charge of training opens sealed and opaque envelopes and informs participants about group allocation. For organisational reasons, he schedules the participants for upcoming assessments and exercise in groups of five. All assessors and study personal other than exercise physiologists are blinded.DiscussionMagnetic Resonance Spectroscopic Imaging gives a deeper insight into mechanisms of exercise-induced changes in brain metabolism. As follow-up lasts for 6 months, this study is able to explore the mid-term cerebral metabolic effects of physical activity assuming that an individually tailored aerobic ergometer training has the potential to counteract brain ageing.Trial registrationNCT02343029 (clinicaltrials.gov; 12 January 2015).
Highlights
Physical activity exerts a variety of long-term health benefits in older adults
Magnetic Resonance Spectroscopic Imaging gives a deeper insight into mechanisms of exercise-induced changes in brain metabolism
This study explores the effects of a supervised aerobic exercise intervention on cerebral metabolism as a correlate of cognitive functioning in cognitively healthy older adults
Summary
This study explores the effects of a supervised aerobic exercise intervention on cerebral metabolism as a correlate of cognitive functioning in cognitively healthy older adults. Studies using functional MRI (fMRI) could show that exercise increases functional connectivity in higher-level cognitive networks, thereby improving executive function [73,74] These studies support a positive effect of physical activity on structural and functional cerebral plasticity in healthy ageing they do not contribute to the clarification of metabolic pathways underlying the observed cognitive improvement. Based on the findings mentioned above the main hypothesis under investigation is that regular physical exercise leads to an enhancement of cerebral energy metabolism in the brains of older people that is closely related to an increase in the concentration of metabolic markers for neuronal viability and density We assume that these changes occur in the hippocampus, are mediated by a release of the neurotrophin BDNF, and predict an improvement of cognitive function including memory and executive control.
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