Changes in cardiovascular health and white matter integrity with aerobic exercise, cognitive and combined training in physically inactive healthy late-middle-aged adults: the "Projecte Moviment" randomized controlled trial

Abstract

Introduction: This is a 12-weeks randomized controlled trial examining the effects of aerobic exercise (AE), computerized cognitive training (CCT) and their combination (COMB). We aim to investigate their impact on cardiovascular health and white matter (WM) integrity and how they contribute to the cognitive benefits.

Methods: 109 participants were recruited and 82 (62% female; age = 58.38 ± 5.47) finished the intervention with > 80% adherence. We report changes in cardiovascular risk factors and WM integrity (fractional anisotropy (FA); mean diffusivity (MD)), how they might be related to changes in physical activity, age and sex, and their potential role as mediators in cognitive improvements.

Results: A decrease in BMI (SMD = - 0.32, p = 0.039), waist circumference (SMD = - 0.42, p = 0.003) and diastolic blood pressure (DBP) (SMD = - 0.42, p = 0.006) in the AE group and a decrease in BMI (SMD = - 0.34, p = 0.031) and DBP (SMD = - 0.32, p = 0.034) in the COMB group compared to the waitlist control group was observed. We also found decreased global MD in the CCT group (SMD = - 0.34; p = 0.032) and significant intervention-related changes in FA and MD in the frontal and temporal lobes in the COMB group.

Conclusions: We found changes in anthropometric measures that suggest initial benefits on cardiovascular health after only 12 weeks of AE and changes in WM microstructure in the CCT and COMB groups. These results add evidence of the clinical relevance of lifestyle interventions and the potential benefits when combining them.

Clinical trial registration: ClinicalTrials.gov NCT031123900.

Keywords: Aerobic exercise; Cardiovascular health; Combined training; Computerized cognitive training; White matter integrity.

Fig. 1

Flow chart

Fig. 2

Significant changes in MD map in COMB group between baseline and follow-up (i.e., effect of time). In blue-light blue clusters with significant decrease of MD (MNI coordinates: 26, − 7, 18). Statistical maps are represented in radiological convention superimposed on an MNI152 template. The threshold for significance was set at p < 0.05 corrected for multiple comparisons across space using family-wise error rate (FWE)

Fig. 3

Significant changes in FA ad MD in COMB group compared to the waitlist control group (i.e., interaction between the effects of time and group allocation). In red-yellow, clusters with significant increase in FA (MNI coordinates: 28, − 14, 26). In blue-light blue, clusters with significant decrease of MD (MNI coordinates: 26, − 7, 18). Statistical maps are represented in radiological convention superimposed on an MNI152 template. The threshold for significance was set at p < 0.05 corrected for multiple comparisons across space using family-wise error rate (FWE)