Exercise has sustained neurocognitive benefit in older adults with cognitive impairment with no dementia

  • Blumenthal JA & al.
  • J Am Geriatr Soc
  • 22 Nov 2019

  • International Clinical Digest
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Takeaway

  • Among older adults with cognitive impairment with no dementia (CIND) and other cardiovascular disease (CVD) risk factors, 6 months of aerobic exercise was associated with persistently better executive function a year after the intervention ended.
  • Dietary Approaches to Stop Hypertension (DASH) also had some benefits.

Why this matters

 Key results

  • At 1 year, executive function is still better:
    • In exercise vs nonexercise groups (Cohen’s d, 0.27; P=.041).
    • In DASH vs non-DASH groups (Cohen’s d, 0.20; P=.054).
  • Change from baseline in executive function:
    • Exercise: +5 years;
    • DASH diet: +5 years;
    • Combination: +7.9 years; and
    • Control: –0.7 years.
  • Six-minute walk distance remained better in exercise vs nonexercise groups (P=.009).
  • Composite CVD risk remained lower in DASH vs non-DASH groups (P=.016).
  • Vs control, exercise-DASH combination yielded better:
    • Executive functioning (P<.001>
    • Clinical Dementia Rating-Sum of Boxes score (P=.011).

Study design

  • Randomised controlled trial, 160 sedentary older adults with CIND, ≥1 additional CVD risk factor (ENLIGHTEN trial).
  • 6 months:
    • Aerobic exercise (35 minutes; 3 times weekly),
    • DASH diet counselling (weekly then biweekly),
    • Combination, and
    • Control (health education by telephone weekly then biweekly).
  • Main outcome: neurocognitive battery.
  • Funding: NIH.

Limitations

  • Single trial site.
  • Smaller sample.