Sedentary older adults with amnestic mild cognitive impairment who engaged in regular physical exercise for per year maintained their cognition without decline, topline data from the EXERT trial showed.
Older adults who engaged in either moderate intensity aerobic training or stretching, balance, and range-of-motion exercises for 12 months showed no differ from baseline in ADAS-Cog-Exec scores, a way of measuring global cognitive function, reported Laura Baker, PhD, of Wake Forest University School of Medicine in Winston-Salem, NEW YORK, at the 2022 Alzheimer’s Association International Conference.
An assessment band of similar older adults with mild cognitive impairment within an observational study — the Alzheimer’s Disease Neuroimaging Initiative (ADNI) — who didn’t have the EXERT interventions showed significant cognitive decline over 12 months, Baker noted.
“An elevated level of supported exercise of at the very least 120 to 150 minutes weekly for 12 months may slow or stall cognitive decline in previously sedentary older adults with mild cognitive impairment,” she said.
EXERT may be the longest-ever phase III study of exercise in older adults with mild cognitive impairment, noted Maria Carrillo, PhD, chief science officer of the Alzheimer’s Association.
These topline findings are “remarkable and encouraging,” Carrillo said. “They claim that regular exercise, even modest or low exertion activity such as for example stretching, may protect brain cells against damage.”
The EXERT trial aimed to check whether 12 months of exercise would improve or protect cognition in sedentary people who have amnestic mild cognitive impairment. Participants with a mean MiniMental State Examination (MMSE) score of 28 and a mean Clinical Dementia Rating scale Amount of Boxes (CDR-SB) score of just one 1.5 were randomized to either aerobic or stretching, balance, and range-of-motion exercise.
Both aerobic and stretching/balance groups exercised four times weekly for approximately 30 to 40 minutes. The aerobic group exercised at a moderate intensity, achieving 70% to 85% heartrate reserve. The stretching/balance group exercised at a minimal intensity, maintaining heartrate reserve below 35%.
In the initial 12 months of the trial, participants were supervised by way of a trainer at the YMCA. For another six months, they continued exercising independently.
A complete of 296 participants signed up for the analysis. Most (57%) were women; about 87% were white and 10% were Black. Mean age was about 74, and 25% were APOE4 carriers.
A lot more than 31,000 exercise sessions were completed in the initial 12 months. Attendance remained high through the entire study, at 81% in the aerobic fitness exercise group and 87% in the stretching/balance group.
Neither the aerobic group nor the stretching/balance group showed decline from baseline on the ADAS-Cog-Exec at 6 or 12 months. There have been no significant treatment differences between your aerobic and stretching/balance groups on these outcomes (P=0.29).
In a usual-care analysis, the researchers compared EXERT participants with those from ADNI matched on demographics, baseline cognitive function, and APOE4 status. ADNI participants showed an expected 12-month decline in ADAS-Cog-Exec scores, however the EXERT aerobic group (P=0.012) and EXERT stretching/balance group (P=0.0005) didn’t.
All EXERT participants received weekly socialization from this program, which might have contributed to the findings, Baker noted. What’s critical is that regular physical exercise should be supported for those who have mild cognitive impairment: it should be supervised and also have a social component, she added.
The analysis was funded by the NIH/National Institute on Aging.
Baker disclosed no relationships with industry.