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Effects of low- and high-intensity physical exercise on physical and cognitive function in older persons with dementia: a randomized controlled trial.
Alzheimers Res Ther. 2020 03 19; 12(1):28.AR

Abstract

BACKGROUND

Potential moderators such as exercise intensity or apolipoprotein-E4 (ApoE4) carriership may determine the magnitude of exercise effects on physical and cognitive functions in patients with dementia (PwD). We determined the effects of a 24-week aerobic and strength training program with a low- and high-intensity phase on physical and cognitive function.

METHODS

In an assessor-blinded randomized trial, 91 PwD (all-cause dementia, recruited from daycare and residential care facilities, age 82.3 ± 7.0 years, 59 women, Mini-Mental State Examination 20.2 ± 4.4) were allocated to the exercise or control group. In the exercise group, PwD participated in a walking and lower limb strength training program with 12 weeks low- and 12 weeks high-intensity training offered three times/week. Attention-matched control participants performed flexibility exercises and recreational activities. We assessed adherence, compliance, and exercise intensity for each session. We assessed physical (endurance, gait speed, mobility, balance, leg strength) and cognitive (verbal memory, visual memory, executive function, inhibitory control, psychomotor speed) functions with performance-based tests at baseline and after 6, 12, 18, 24, and 36 weeks (follow-up). ApoE4 carriership was determined post-intervention.

RESULTS

Sixty-nine PwD were analyzed. Their mean attendance was ~ 60% during the study period. There were no significant effects of the exercise vs. control intervention on endurance, mobility, balance, and leg strength in favor of the exercise group (Cohen's d = 0.13-0.18). Gait speed significantly improved with ~ 0.05 m/s after the high-intensity phase for exercise participants (Cohen's d = 0.41) but declined at follow-up. There were no significant effects of the exercise vs. control intervention on any of the cognitive measures (Cohen's d ~ - 0.04). ApoE4 carriership did not significantly moderate exercise effects on physical or cognitive function.

CONCLUSIONS

Exercise was superior to control activities for gait speed in our sample of PwD. However, the training effect provided no protection for mobility loss after detraining (follow-up). There were no beneficial effects of the exercise vs. control group on cognitive function. Exercise intensity moderated the effects of exercise on gait speed. ApoE4 carriership moderated the effect of exercise on global cognition only (trend level).

TRIAL REGISTRATION

Netherlands Trial Register, NTR5035. Registered on 2 March 2015.

Authors+Show Affiliations

Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands. l.m.j.sanders@umcg.nl.Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.Department of Geriatric Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.Groningen Institute for Evolutionary Life Sciences (GELIFES), University of Groningen, Nijenborgh 7, 9747 AG, Groningen, The Netherlands.Department of Clinical Neuropsychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32192537

Citation

Sanders, L M J., et al. "Effects of Low- and High-intensity Physical Exercise On Physical and Cognitive Function in Older Persons With Dementia: a Randomized Controlled Trial." Alzheimer's Research & Therapy, vol. 12, no. 1, 2020, p. 28.
Sanders LMJ, Hortobágyi T, Karssemeijer EGA, et al. Effects of low- and high-intensity physical exercise on physical and cognitive function in older persons with dementia: a randomized controlled trial. Alzheimers Res Ther. 2020;12(1):28.
Sanders, L. M. J., Hortobágyi, T., Karssemeijer, E. G. A., Van der Zee, E. A., Scherder, E. J. A., & van Heuvelen, M. J. G. (2020). Effects of low- and high-intensity physical exercise on physical and cognitive function in older persons with dementia: a randomized controlled trial. Alzheimer's Research & Therapy, 12(1), 28. https://doi.org/10.1186/s13195-020-00597-3
Sanders LMJ, et al. Effects of Low- and High-intensity Physical Exercise On Physical and Cognitive Function in Older Persons With Dementia: a Randomized Controlled Trial. Alzheimers Res Ther. 2020 03 19;12(1):28. PubMed PMID: 32192537.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of low- and high-intensity physical exercise on physical and cognitive function in older persons with dementia: a randomized controlled trial. AU - Sanders,L M J, AU - Hortobágyi,T, AU - Karssemeijer,E G A, AU - Van der Zee,E A, AU - Scherder,E J A, AU - van Heuvelen,M J G, Y1 - 2020/03/19/ PY - 2019/05/27/received PY - 2020/03/11/accepted PY - 2020/3/21/entrez PY - 2020/3/21/pubmed PY - 2021/6/23/medline KW - ApoE4 KW - Cognitive decline KW - Dementia KW - Dose-response relationship KW - Exercise intensity KW - Physical exercise SP - 28 EP - 28 JF - Alzheimer's research & therapy JO - Alzheimers Res Ther VL - 12 IS - 1 N2 - BACKGROUND: Potential moderators such as exercise intensity or apolipoprotein-E4 (ApoE4) carriership may determine the magnitude of exercise effects on physical and cognitive functions in patients with dementia (PwD). We determined the effects of a 24-week aerobic and strength training program with a low- and high-intensity phase on physical and cognitive function. METHODS: In an assessor-blinded randomized trial, 91 PwD (all-cause dementia, recruited from daycare and residential care facilities, age 82.3 ± 7.0 years, 59 women, Mini-Mental State Examination 20.2 ± 4.4) were allocated to the exercise or control group. In the exercise group, PwD participated in a walking and lower limb strength training program with 12 weeks low- and 12 weeks high-intensity training offered three times/week. Attention-matched control participants performed flexibility exercises and recreational activities. We assessed adherence, compliance, and exercise intensity for each session. We assessed physical (endurance, gait speed, mobility, balance, leg strength) and cognitive (verbal memory, visual memory, executive function, inhibitory control, psychomotor speed) functions with performance-based tests at baseline and after 6, 12, 18, 24, and 36 weeks (follow-up). ApoE4 carriership was determined post-intervention. RESULTS: Sixty-nine PwD were analyzed. Their mean attendance was ~ 60% during the study period. There were no significant effects of the exercise vs. control intervention on endurance, mobility, balance, and leg strength in favor of the exercise group (Cohen's d = 0.13-0.18). Gait speed significantly improved with ~ 0.05 m/s after the high-intensity phase for exercise participants (Cohen's d = 0.41) but declined at follow-up. There were no significant effects of the exercise vs. control intervention on any of the cognitive measures (Cohen's d ~ - 0.04). ApoE4 carriership did not significantly moderate exercise effects on physical or cognitive function. CONCLUSIONS: Exercise was superior to control activities for gait speed in our sample of PwD. However, the training effect provided no protection for mobility loss after detraining (follow-up). There were no beneficial effects of the exercise vs. control group on cognitive function. Exercise intensity moderated the effects of exercise on gait speed. ApoE4 carriership moderated the effect of exercise on global cognition only (trend level). TRIAL REGISTRATION: Netherlands Trial Register, NTR5035. Registered on 2 March 2015. SN - 1758-9193 UR - https://www.unboundmedicine.com/medline/citation/32192537/Effects_of_low__and_high_intensity_physical_exercise_on_physical_and_cognitive_function_in_older_persons_with_dementia:_a_randomized_controlled_trial_ DB - PRIME DP - Unbound Medicine ER -