Abstract
BackgroundExercise interventions to prevent dementia and delay cognitive decline have gained considerable attention in recent years. Human and animal studies have demonstrated that regular physical activity targets brain function by increasing cognitive reserve. There is also evidence of structural changes caused by exercise in preventing or delaying the genesis of neurodegeneration. Although initial studies indicate enhanced cognitive performance in patients with mild cognitive impairment (MCI) following an exercise intervention, little is known about the effect of an extensive, controlled and regular exercise regimen on the neuropathology of patients with MCI. This study aims to determine the effects of an extensive exercise programme on the progression of MCI.Methods/designThis randomised controlled clinical intervention study will take place across three European sites. Seventy-five previously sedentary patients with a clinical diagnosis of MCI will be recruited at each site. Participants will be randomised to one of three groups. One group will receive a standardised 1-year extensive aerobic exercise intervention (3 units of 45 min/week). The second group will complete stretching and toning (non-aerobic) exercise (3 units of 45 min/week) and the third group will act as the control group. Change in all outcomes will be measured at baseline (T0), after six months (T1) and after 12 months (T2). The primary outcome, cognitive performance, will be determined by a neuropsychological test battery (CogState battery, Trail Making Test and Verbal fluency). Secondary outcomes include Montreal Cognitive Assessment (MoCA), cardiovascular fitness, physical activity, structural changes of the brain, quality of life measures and measures of frailty. Furthermore, outcome variables will be related to genetic variations on genes related to neurogenesis and epigenetic changes in these genes caused by the exercise intervention programme.DiscussionThe results will add new insights into the prevailing notion that exercise may slow the rate of cognitive decline in MCI.Trial registrationClinicalTrials.gov NCT02913053
Highlights
Exercise interventions to prevent dementia and delay cognitive decline have gained considerable attention in recent years
The results will add new insights into the prevailing notion that exercise may slow the rate of cognitive decline in mild cognitive impairment (MCI)
Study aims The primary aim of this study is to investigate the effects a 12-month structured exercise programme compared to a control group for the progression of cognitive decline in MCI
Summary
Exercise interventions to prevent dementia and delay cognitive decline have gained considerable attention in recent years. Initial studies indicate enhanced cognitive performance in patients with mild cognitive impairment (MCI) following an exercise intervention, little is known about the effect of an extensive, controlled and regular exercise regimen on the neuropathology of patients with MCI. This study aims to determine the effects of an extensive exercise programme on the progression of MCI. Patients with MCI in the earliest stage of neurodegeneration can be clinically diagnosed, and represent a patient cohort consistently able to participate in a structured exercise programme. There has been an increased research focus on both pharmacological and non-pharmacological strategies to optimise cognitive function and enhance ‘brain health’ in older age [5], for individuals at risk of developing AD [6]
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