Exercise sharpens executive function in older adults with mild impairment

  • Neurology

  • curated by Susan London
  • Clinical Essentials
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Takeaway

  • Aerobic exercise improved executive functioning in sedentary older adults with mild cognitive impairment and cardiovascular disease (CVD) risk factors, whereas the Dietary Approaches to Stop Hypertension (DASH) diet did not.

Why this matters

  • Dementia risk is elevated for patients with impaired cognition.

Key results

  • With health education as comparator, executive function:
    • improved with aerobic exercise (d, 0.32; P=.046),
    • marginally improved with DASH diet (d, 0.30; P=.059), and
    • improved most with combination (d, 0.40; P=.012).
  • Factors linked to greater improvement in executive function:
    • Higher aerobic fitness assessed from peak VO2 (b, 2.3; P=.049).
    • Lower CVD risk (b, 2.6; P<.042>
    • Lower sodium intake (b, 0.18; P=.024).
  • No significant improvements seen in memory, language/verbal fluency.

Study design

  • Single-center randomized controlled trial among 160 sedentary patients aged >55 years having mild, preclinical cognitive impairments plus CVD risk factors (ENLIGHTEN trial).
  • Randomization to 6 months of:
    • Aerobic exercise (3 times/week at 70%-85% initial peak heart rate reserve).
    • DASH diet nutritional counseling (weekly, biweekly sessions with nutritionist).
    • Both combined.
    • Health education control.
  • Main outcome: executive function.
  • Funding: NIH.

Limitations

  • Participants highly motivated.
  • Trial fairly short, possibly underpowered.
  • Preferential inclusion of patients with frontal lobe deficits, vascular cognitive impairment.

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