Abstract
Patients with known vascular disease are at increased risk for cognitive impairments. Exercise has been shown to improve cognition in healthy elderly populations and those with mild cognitive impairments. We explored the literature to understand exercise as a modality to improve cognition in those with vascular disease, focusing on dose-responses. A systematic review was conducted through 2017 using Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Ovid Embase, and Ovid MEDLINE databases. Eligible studies examined effects of exercise on memory and cognition in cardiovascular (CVD) or cerebrovascular disease (CBVD). Data extracted included group characteristics, exercise dosage and outcomes measures employed. Twenty-two studies (12 CVD, 10 CBVD) met the inclusion criteria. Interventions included aerobic, resistance, or mixed training, with neuropsychological test batteries assessing cognition. In CVD populations, five studies demonstrated improved cardiovascular fitness and cognition with aerobic training, and another seven studies suggested a dose-response. In CBVD trials, four studies reported improved cognition, with no effects observed in the fifth study. Another study found enhanced cognition with resistance training and four demonstrated a positive association between functional capacity and cognition following combined aerobic and resistance training. Exercise is able to positively affect cognitive performance in those with known vascular disease. There is evidence to suggest a dose–response relationship. Further research is required to optimize prescription.
Highlights
According to the World Health Organization, cardiovascular disease (CVD) is the foremost noncommunicable disease (NCD) worldwide, contributing to 17 million deaths (48% of NCD deaths) annually and 10% of the global disease burden [1]
Along with the more evident health issues which present with CVD, there is evidence indicating individuals with CVD may be at risk for deteriorating cognition, including memory functions, which is independent of age-related decline [4]
Carles et al (2007) examined the effect of brief bouts of exercise on cognition and found that participants’ performance on tracking tasks improved when completed during exercise compared to at rest, while cognitive solicitation tasks only improved following 2 weeks of aerobic exercise training [38]. These findings suggest that both brief bouts of exercise and aerobic exercise training can produce cognitive benefits and that exercise training may improve the effect of acute exercise on cognitive function
Summary
According to the World Health Organization, cardiovascular disease (CVD) is the foremost noncommunicable disease (NCD) worldwide, contributing to 17 million deaths (48% of NCD deaths) annually and 10% of the global disease burden [1]. Cerebrovascular disease (CBVD) is another source of high morbidity and mortality across Europe and globally, with the prevalence increasing in some younger adult populations [5,6]. It has been reported that, for every symptomatic stroke, there are approximately 10 silent brain infarcts [7]. With these alarming statistics, there is a call to better understand this pathophysiology and, more importantly, to find the most appropriate interventions for preventing, delaying or mitigating cognitive decline in those with CVD and CBVD. To provide a context for our review, we explored the literature for areas of research shedding light on the links between CVD and CBVD and cognitive decline
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