Effects of Aerobic Exercise on Mild Cognitive Impairment methods
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Methods
The study was approved by the University of Washington institutional review board. Thirty-three subjects diagnosed with amnestic MCI (single or multiple domain) using Petersen criteria in a memory disorders clinic provided written informed consent and were enrolled in the study. Exclusion criteria included unstable cardiac disease, significant cerebrovascular disease, musculoskeletal impairment, or presence of other medical conditions with significant psychiatric, neurologic, or metabolic sequela. Only sedentary adults (self-report of <30 minutes of structured physical activity <3 times per week in the last 6 months, confirmed with peak oxygen consumption during graded exercise treadmill test) were enrolled. Use of statins or antihypertensives was permitted, while use of diabetes medications was not. At enrollment, the aerobic and control groups were comparable with respect to age, ge...
Intervention
Participants were randomized either to a high-intensity aerobic exercise or stretching control group. The aerobic group exercised under the supervision of a fitness trainer at 75% to 85% of heart rate reserve for 45 to 60 min/d, 4 d/wk for 6 months. The control group carried out supervised stretching activities according to the same schedule but maintained their heart rate at or below 50% of their heart rate reserve. Before and after the study, glucometabolic and treadmill tests were performed and fat distribution was assessed using dual-energy x-ray absorptiometry. At baseline, month 3, and month 6, blood was collected for assay and cognitive tests were administered.
Procedure
Participants in both the aerobic and stretching groups carried out their activity routines 4 d/wk for 45 to 60 minutes per session for 6 months. Participants maintained a constant diet and extracurricular activity level for the duration of the study. Most exercise sessions (90%) were conducted at local Young Mens Christian Associations (YMCA). The first 8 sessions were supervised by the trainer. Thereafter, the trainer supervised 1 session per week per participant. Subjects also received a weekly call from the study coordinator to ensure compliance and completed daily logs tracking exercise duration and heart rate (HR) monitor measurements. Compliance data were reviewed weekly by an exercise physiologist. Exercise duration and intensity were gradually increased over the first 6 weeks of the program until participants in the aerobic group were exercising at 75% to 85% of HR reserve usi...
Hyperinsulinemic-Euglycemic Clamp
At baseline and following the 6-month intervention, fasting participants received a hyperinsulinemic-euglycemic clamp, as previously described. The quantity of dextrose infusate (mL) required to maintain euglycemia under the condition of steady-state hyperinsulinemia for 30 minutes was recorded. Values were adjusted for the volume of insulin infused in 30 minutes (mU/kg); greater values reflected increased glucose disposal and, consequently, increased insulin sensitivity.
Cognitive Function
Six months of controlled aerobic exercise improved executive control processes of multitasking, cognitive flexibility, information processing efficiency, and selective attention (Symbol-Digit Modalities, Verbal Fluency, Stroop, Trails B, and Task Switching; MANOVA, F 5,19 =3.05; P =.04). When sex was included in the model as a predictor variable, a significant interaction indicated that this treatment effect differed for men and women (group × sex F 5,17 =2.98; P =.04). For women, increasing V̇ o 2 peak was associated with improved executive function ( P =.05). The results of univariate analyses for the constituent cognitive tests are provided below. A similarly structured MANOVA performed on measures collected 3 months into the study failed to reach significance, likely because participants had only completed 6 weeks of the program at the targeted intensity.
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Evidence quotes (5)
The study was approved by the University of Washington institutional review board. Thirty-three subjects diagnosed with amnestic MCI (single or multiple domain) using Petersen criteria in a memory disorders clinic provided written informed consent and were enrolled in the study. Exclusion criteria included unstable cardiac disease, significant cerebrovascular disease, musculoskeletal impairment, or presence of other medical conditions with significant psychiatric, neurologic, or metabolic sequela. Only sedentary adults (self-report of <30 minutes of structured physical activity <3 times per week in the last 6 months, confirmed with peak oxygen consumption during graded exercise treadmill test) were enrolled. Use of statins or antihypertensives was permitted, while use of diabetes medications was not. At enrollment, the aerobic and control groups were comparable with respect to age, general cognitive status, cardiorespiratory fitness, adiposity, insulin sensitivity, and fasting plasma levels of insulin, cholesterol, IGF-I, and cortisol ( P >.17 for all). Overall, women at baseline had higher Mini-Mental State Examination scores, body fat, cholesterol (total and high-density lipo...
Participants were randomized either to a high-intensity aerobic exercise or stretching control group. The aerobic group exercised under the supervision of a fitness trainer at 75% to 85% of heart rate reserve for 45 to 60 min/d, 4 d/wk for 6 months. The control group carried out supervised stretching activities according to the same schedule but maintained their heart rate at or below 50% of their heart rate reserve. Before and after the study, glucometabolic and treadmill tests were performed and fat distribution was assessed using dual-energy x-ray absorptiometry. At baseline, month 3, and month 6, blood was collected for assay and cognitive tests were administered.
Participants in both the aerobic and stretching groups carried out their activity routines 4 d/wk for 45 to 60 minutes per session for 6 months. Participants maintained a constant diet and extracurricular activity level for the duration of the study. Most exercise sessions (90%) were conducted at local Young Mens Christian Associations (YMCA). The first 8 sessions were supervised by the trainer. Thereafter, the trainer supervised 1 session per week per participant. Subjects also received a weekly call from the study coordinator to ensure compliance and completed daily logs tracking exercise duration and heart rate (HR) monitor measurements. Compliance data were reviewed weekly by an exercise physiologist. Exercise duration and intensity were gradually increased over the first 6 weeks of the program until participants in the aerobic group were exercising at 75% to 85% of HR reserve using a treadmill, stationary bicycle, or elliptical trainer. This intensity was then maintained for the study's duration. The treadmill was the most commonly selected machine, regardless of sex. Participants in the control group carried out a prescribed routine of stretching and balance exercises, mai...
At baseline and following the 6-month intervention, fasting participants received a hyperinsulinemic-euglycemic clamp, as previously described. The quantity of dextrose infusate (mL) required to maintain euglycemia under the condition of steady-state hyperinsulinemia for 30 minutes was recorded. Values were adjusted for the volume of insulin infused in 30 minutes (mU/kg); greater values reflected increased glucose disposal and, consequently, increased insulin sensitivity.
Six months of controlled aerobic exercise improved executive control processes of multitasking, cognitive flexibility, information processing efficiency, and selective attention (Symbol-Digit Modalities, Verbal Fluency, Stroop, Trails B, and Task Switching; MANOVA, F 5,19 =3.05; P =.04). When sex was included in the model as a predictor variable, a significant interaction indicated that this treatment effect differed for men and women (group × sex F 5,17 =2.98; P =.04). For women, increasing V̇ o 2 peak was associated with improved executive function ( P =.05). The results of univariate analyses for the constituent cognitive tests are provided below. A similarly structured MANOVA performed on measures collected 3 months into the study failed to reach significance, likely because participants had only completed 6 weeks of the program at the targeted intensity.
Machine-readable layer
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