Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2018;65(1):137-145.
doi: 10.3233/JAD-180253.

Change in Fitness and the Relation to Change in Cognition and Neuropsychiatric Symptoms After Aerobic Exercise in Patients with Mild Alzheimer's Disease

Nanna A Sobol  1 , Christian Have Dall  1   2 , Peter Høgh  3 , Kristine Hoffmann  4 , Kristian Steen Frederiksen  4 , Asmus Vogel  4 , Volkert Siersma  5 , Gunhild Waldemar  4 , Steen G Hasselbalch  4 , Nina Beyer  1
Affiliations
Randomized Controlled Trial

Change in Fitness and the Relation to Change in Cognition and Neuropsychiatric Symptoms After Aerobic Exercise in Patients with Mild Alzheimer's Disease

Nanna A Sobol et al. J Alzheimers Dis. 2018.

Abstract

Background: Physical activity has the potential to improve physical function in patients with Alzheimer's disease (AD) and may contribute to modify disease processes and cognitive function.

Objective: The aim of this study was to investigate 1) the effect of moderate-high-intensity aerobic exercise on cardiorespiratory fitness, i.e., peak oxygen uptake (VO2peak) determined by direct breath-by-breath cardiopulmonary exercise test, and 2) the association between changes in VO2peak and changes in cognition and neuropsychiatric symptoms in patients with mild AD.

Methods: The study is based on secondary outcome analyses from the large single-blinded multi-center study ADEX (Preserving Cognition, Quality of Life, Physical Health and Functional Ability in Alzheimer's Disease: The Effect of Physical Exercise). A preselected sub-group of 55 participants (age 52-83 years), 29 from the intervention group (IG) and 26 from the control group (CG), was included. IG performed 16 weeks of supervised moderate-to-high intensity aerobic exercise. Assessments of VO2peak, mental speed and attention (Symbol Digit Modalities Test, SDMT), and neuropsychiatric symptoms (Neuropsychiatric Inventory, NPI) were performed at baseline and at 16 weeks.

Result: VO2peak increased 13% in the IG and a between-group difference in mean change (3.92 ml/kg/min, 95% CI 6.34-1.51, p = 0.003) was present in favor of the IG. Combined data from IG and CG showed positive associations between changes in VO2peak and changes in NPI (Rho = - 0.41, p = 0.042) and changes in SDMT (Rho = 0.36, p = 0.010), respectively.

Conclusion: Aerobic exercise improves VO2peak in community-dwelling patients with mild AD. Furthermore, changes in VO2peak appear to be associated to changes in cognition and neuropsychiatric symptoms.

Keywords: Alzheimer’s disease; aerobic exercise; cardiorespiratory fitness; cognitive function; neuropsychiatric symptoms.

PubMed Disclaimer

Figures

Fig.1
Fig.1
Flowchart of the sub-group study in ADEX.
Fig.2
Fig.2
Correlation between changes in VO2peak and changes in NPI (n = 49), Rho = – 0.41, p = 0.042. NPI, Neuropsychiatric Inventory, score range 0–144, with higher scores indicating increased behavioral and psychological symptoms.
Fig.3
Fig.3
Correlation between changes in VO2peak and changes in SDMT (n = 47), Rho = 0.36, p = 0.010. SDMT, Symbol Digit Modalities Test are the number of correct matches in 120 s, with a higher score indicating a higher level of mental speed and attention.
See this image and copyright information in PMC

References

    1. Forbes D, Forbes SC, Blake CM, Thiessen EJ, Forbes S (2015) Exercise programs for people with dementia. Cochrane Database Syst Rev 4, CD006489. - PMC - PubMed
    1. Blankevoort CG, van Heuvelen MJ, Boersma F, Luning H, de Jong J, Scherder EJ (2010) Review of effects of physical activity on strength, balance, mobility and ADL performance in elderly subjects with dementia. Dement Geriatr Cogn Disord 30, 392–402. - PubMed
    1. Littbrand H, Stenvall M, Rosendahl E (2011) Applicability and effects of physical exercise on physical and cognitive functions and activities of daily living among people with dementia: A systematic review. Am J Phys Med Rehabil 90, 495–518. - PubMed
    1. Phillips C, Akif Baktir M, Das D, Lin B, Salehi A (2015) The link between physical activity and cognitive dysfunction in Alzheimer disease. Phys Ther 95, 1046–1060. - PubMed
    1. Burns JM, Cronk BB, Anderson HS, Donnelly JE, Thomas GP, Harsha A, Brooks WM, Swerdlow RH (2008) Cardiorespiratory fitness and brain atrophy in early Alzheimer disease. Neurology 71, 210–216. - PMC - PubMed

Publication types