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Physical Activity Improves Verbal and Spatial Memory in Older Adults with Probable Mild Cognitive Impairment: A 6-Month Randomized Controlled Trial

  • University of British Columbia

Abstract and Figures

We report secondary findings from a randomized controlled trial on the effects of exercise on memory in older adults with probable MCI. We randomized 86 women aged 70-80 years with subjective memory complaints into one of three groups: resistance training, aerobic training, or balance and tone (control). All participants exercised twice per week for six months. We measured verbal memory and learning using the Rey Auditory Verbal Learning Test (RAVLT) and spatial memory using a computerized test, before and after trial completion. We found that the aerobic training group remembered significantly more items in the loss after interference condition of the RAVLT compared with the control group after six months of training. In addition, both experimental groups showed improved spatial memory performance in the most difficult condition where they were required to memorize the spatial location of three items, compared with the control group. Lastly, we found a significant correlation between spatial memory performance and overall physical capacity after intervention in the aerobic training group. Taken together, our results provide support for the prevailing notion that exercise can positively impact cognitive functioning and may represent an effective strategy to improve memory in those who have begun to experience cognitive decline.
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Journal of Aging Research
Volume , Article ID ,  pages.//
Research Article
Physical Activity Improves Verbal and Spatial Memory
in Older Adults with Probable Mild Cognitive Impairment:
A 6-Month Randomized Controlled Trial
Lindsay S. Nagamatsu,1Alison Chan,2Jennifer C. Davis,2B. Lynn Beattie,3,4 Peter Graf,1
Michelle W. Voss,5Devika Sharma,2and Teresa Liu-Ambrose2,4
3Alzheimer Clinic, G37 Purdy Pavilion, UBC Hospital, University of British Columbia (UBC), 2211 Wesbrook Mall, Vancouver, BC,
Canada V6T 2B5
4Brain Research Centre, University of British Columbia (UBC), 2211 Wesbrook Mall, Vancouver, BC,
Canada V6T 2B5
5Department of Psychology, e University of Iowa, E11 Seashore Hall, Iowa City, IA 52242-1409, USA
Correspondence should be addressed to Teresa Liu-Ambrose;
Received  November ; Accepted  January 
Academic Editor: Louis Bherer
Copyright ©  Lindsay S. Nagamatsu et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
We report secondary ndings from a randomized controlled trial on the eects of exercise on memory in older adults with probable
MCI. We randomized  women aged – years with subjective memory complaints into one of three groups: resistance training,
aerobic training, or balance and tone (control). All participants exercised twice per week for six months. We measured verbal
memory and learning using the Rey Auditory Verbal Learning Test (RAVLT) and spatial memory using a computerized test,
before and aer trial completion. We found that the aerobic training group remembered signicantly more items in the loss aer
interference condition of the RAVLT compared with the control group aer six months of training. In addition, both experimental
groups showed improved spatial memory performance in the most dicult condition where they were required to memorize the
spatial location of three items, compared with the control group. Lastly, we found a signicant correlation between spatial memory
performance and overall physical capacity aer intervention in the aerobic training group. Taken together, our results provide
support for the prevailing notion that exercise can positively impact cognitive functioning and may represent an eective strategy
to improve memory in those who have begun to experience cognitive decline.
1. Introduction
Cognitive decline is one of the most pressing health care
issues of the st century. Currently worldwide, one new
case of dementia is detected every seven seconds []and
the number of people aected is projected to be over 
million by  []. us, the societal value of developing
eective intervention strategies cannot be overstated [].
To date, pharmacological interventions for dementia have
remained medically challenging at best. As a result, there has
been growing interest in exercise training as an alternative
intervention strategy.
e primary aim of our current study was to investigate
the ecacy of exercise as an intervention strategy to improve
memory performance in older adults who have already
begun to experience cognitive decline—namely, those with
mild cognitive impairment (MCI). MCI is characterized
by cognitive decline that is greater than expected for an
individual’s age and education level, but does not signicantly
interfere with everyday function (i.e., instrumental activities
Journal of Aging Research
of daily living) []. Importantly, MCI is a well-recognized risk
factor for dementia; longitudinal studies report that seniors
with MCI develop Alzheimer’s disease at a rate of –%
annually [,], compared to -% of seniors without MCI
[]. us, MCI represents a critical window of opportunity
to intervene and alter the trajectory of both cognitive and
functional decline in seniors.
Exercise is a promising strategy for improving cognitive
functions. Previous research has found that both resistance
training [,] and aerobic training [] positively impact
cognitive functioning and result in functional plasticity in
healthy older adults. Furthermore, emerging evidence also
suggests that exercise training has cognitive benets for
seniors with MCI. For example, a -week home-based
physical activity program improved performance on the
Alzheimer Disease Assessment Scale-Cognitive Subscale in
seniors with probable MCI []. Additionally, a six-month
aerobic training program improved selective attention and
conict resolution, processing speed, and verbal uency in
senior women with amnestic MCI [].
Expanding upon the existing body of knowledge on
exercise and cognitive functions, we found that twice-weekly
progressive resistance training in our six-month interven-
tion improved associative memory—or the memorization of
two items in conjunction—in senior women with probable
MCI []. ese ndings were further corroborated by our
neuroimaging results, where resistance training was asso-
ciated with increased activation over time in key cortical
regions that subserve associative memory. Importantly, other
research groups have found complementary evidence for
a relationship between physical activity and memory in
seniors with MCI []. However, a comparison has not been
conducted between resistance and aerobic training for their
propensity to improve various forms of memory in older
adults who are showing signs of memory decline.
For our study reported here, we analyzed the secondary
outcome measures of our randomized controlled trial that
was previously published []. Our current analysis was
primarily designed to examine the ecacy of both resistance
training and aerobic training to improve memory perfor-
mance in senior women with probable MCI. To this end,
we examined the impact of exercise on two distinct forms
of memory: () verbal memory and learning and () spatial
memory. e second aim of our study was to determine
whether memory performance at the end of the trial might
be associated with physical performance measures. While
research on the eects of resistance training on cognitive
function has been limited, preliminary evidence does suggest
that dierent forms of exercise (e.g., aerobic versus resistance
training) alter distinct cognitive processes [,]. Consis-
tent with this idea, Cassilhas and colleagues []recently
reported dierences in underlying molecular mechanisms
between the two types of exercise for how they may improve
cognitive function; whereas resistance training appeared to
increase levels of serum IFG-, aerobic training increased
levels of brain-derived neurotrophic factors (BDNF) in the
hippocampus. erefore, we hypothesized that both types
of exercise training would yield benecial—although poten-
tially divergent—impacts on memory.
2. Methods
2.1. Study Design. We conducted a -week, single-blinded,
randomized trial of exercise (NCT) with assess-
ments at baseline, mid-point, and trial completion. Details of
the trial have been reported elsewhere [].
2.2. Participants. Our study only included women due to
sex dierences in cognitive response to exercise []. From
April  to August , we recruited participants using
advertisements in local media and a memory clinic. Individ-
uals were screened by a standardized telephone interview and
by a -minute in-person assessment. Women who lived in
Vancouver, Canada, were eligible for study entry if they ()
were aged  to  years; () were living independently in
their own home; () scored / on the Mini-Mental State
Examination (MMSE); () scored </ on the Montreal
Cognitive Assessment (MoCA) []; () answered “yes” to the
() scored / on the Lawton and Brody []Instrumental
Activities of Daily Living; () had a visual acuity of at least
/, with or without corrective lenses; and () obtained
their physicians clearance to start a supervised exercise
program. We excluded those who () had a current medical
condition for which exercise is contraindicated; () had par-
ticipated regularly in resistance training or aerobic training
in the last six months; () had a neurodegenerative disease
and/or stroke; () had a diagnosed psychiatric condition (e.g.,
depression); () had a diagnosis of dementia of any type; ()
did not speak and understand English uently; or () were on
oestrogen replacement therapy.
In Figure ,theCONSORT(ConsolidatedStandardsof
Reporting Trial) owchart shows the number and distri-
bution of participants. Ethical approval was obtained from
the Vancouver Coastal Health Research Institute and the
University of British Columbias Clinical Research Ethics
Board. All participants provided written informed consent.
2.3. Descriptive Variables. Current level of physical activity
was determined by the Physical Activities Scale for the
Elderly (PASE) self-report questionnaire []. e -item
Geriatric Depression Scale [] screened for depression. e
Functional Comorbidity Index was calculated to estimate the
degree of comorbidity associated with physical functioning
[]. We used the Lawton and Brody []Instrumental
Activities of Daily Living Scale to subjectively assess ability
to perform daily activities.
2.4. Verbal Memory and Learning. e Rey Auditory Verbal
Learning Test (RAVLT) [] assessed verbal memory and
learning. Participants were read a list of  common words
ve times. Immediately aer each time, they were required
to recall as many words as possible. Aer the h trial,
an interference list was presented, aer which participants
had to spontaneously recall the original words. Finally, par-
ticipants were required to spontaneously recall the original
words aer a  minute delay. Scores were calculated as
Journal of Aging Research
Flyer advertisement in a
hospital memory clinic
General newspaper,
television, flyer, radio, and
email advertisements
Telephone screen
285 screened
111 excluded
58 eligible based on phone screen but no longer interested
In person screening session
116 screened
25 excluded
4 eligible but no longer interested
87 consented and booked for baseline assessment
Baseline assessment
86 completed the assessment
1 withdrew
86 randomized
2𝑥/week resistance training
𝑛=28 2𝑥/week balance and tone
𝑛=28 2𝑥/week walking program
1 withdrew 6withdrew
(5 =no interest;
Midpoint assessment
Final assessment Final assessment Final assessment
Midpoint assessment Midpoint assessment
26 completed 28 completed 23 completed
26 completed 27 completed 24 completed
1 did not complete
midpoint assessment
1did not complete
midpoint assessment
1did not complete nal
1did not complete
nal assessment
77 completed trial and included in analysis
(1=no interest)
(1 =health)
(1 =health) (1 =health)
F : e CONSORT (Consolidated Standards of Reporting Trials) owchart.
(total acquisition); () aer the interference list (recall aer
interference); () on the h trial minus aer the interference
(loss aer interference); and () aer the delay (long delay free
2.5. Spatial Memory. Spatial memory was assessed using a
computerized task developed in-house by one of our co-
authors along with her collaborators. is task was chosen
because it has previously been found to modulate with
physical activity [] and allows for the collection of
reaction times and accuracy—rather than just working mem-
ory span which other spatial memory tasks provide. Our
location of dots presented on a screen. Specically, one, two,
or three dots appeared at randomly selected locations on the
screen for  ms. Next, a xation-cross appeared for s. At
the screen, either at the same location as one of the previous
black dots (match), or at a new location (nonmatch). Subjects
Journal of Aging Research
T 
Variabl e aBAT
Mean (SD) Mean (SD) Mean (SD) Mean (SD)
Age, years . (.) . (.) . (.) . (.)
Height, cm . (.) . (.) . (.) . (.)
Weight, kg . (.) . (.) . (.) . (.)
Physical activity scale for the elderly . (.) . (.) . (.) . (.)
Education, No (%)
Less than grade   ()  (.)  (  (.)
Grade  to  without certicate or diploma (.)  (.)  (.)  (.)
High school certicate or diploma  (.)  (.)  (.)  (.)
Trades or professional certicate or diploma  (.)  (.)  (.)  (.)
University certicate or diploma (.) (.) (.) (.)
University degree  (.)  (.)  (.)  (.)
Geriatric depression scaleb. (.) . (.) . (.) . (.)
Functional comorbidities indexc. (.) . (.) . (.) . (.)
Instrumental activities of daily livingd. (.) . (.) . (.) . (.)
Montreal cognitive assessmente. (.) . (.) . (.) . (.)
Minimental state examinationf. (.) . (.) . (.) . (.)
Exercise class compliance, %  (.)  (.)  (.)  (.)
Abbreviations: BAT: balance and tone; AT: aerobic training; RT: resistance training.
aUnless otherwise indicated, data are expressed as mean (SD). Percentages (%) have been rounded and may not total .
bMaximum was  points.
cMaximum was  points.
dMaximum was  points.
eMaximum was  points.
fMaximum was  points.
were required to indicate whether the red test dot was a match
or a nonmatch to any of the previously presented black dots
by pressing the designated key on a computer keyboard (“x”
= nonmatch; “m” = match). Participants were instructed to
 match and  nonmatch conditions). Participants were
provided with practice trials prior to beginning the test to
ensure they understood the task instructions. Reaction times
and accuracy were recorded.
2.6. Choice Reaction Time. Choice reaction times were col-
computerized tasks measuring reaction times to account for
dierences in basic processing speed secondary to memory
performance []. Participants were required to indicate
screen was higher or lower than the number “”. Numbers
were presented individually for  ms in the centre of the
and another button with their middle nger if the number
was “lower” than ve. Participants were instructed to respond
as quickly and accurately as possible.
2.7. Physical Performance. General balance and mobility was
assessed using the Short Physical Performance Battery, which
is a composite score of the following tasks: () tandem
standing; () four-metre walk (gait speed); and () chair
stands. General cardiovascular capacity was assessed using
the Six-Minute Walk Test, where the total distance walked
at participants’ usual pace in six minutes was measured in
2.8. Randomization. e randomization sequence was gener-
ated by ( and was concealed
until interventions were assigned. is sequence was held
independently and remotely by the Research Coordinator.
Participants were enrolled and randomized by the Research
Coordinator to the twice-weekly exercise groups: resistance
training (RT), aerobic training (AT), or balance and tone
2.9. Exercise Intervention. e exercise protocol has been
reported elsewhere []. Briey, classes began one month
aer baseline assessments and were held at a fully equipped
gym in a research centre. Classes were led by certied
tness instructors who received additional training from the
study investigators. e classes were  minutes in duration
(-minute warm-up,  minutes of core content, and -
minute cool-down). Attendance was recorded daily, which
Journal of Aging Research
was used to calculate compliance (i.e., percentage of total
classes attended). Strategies were implemented to promote
participant engagement [,].
2.9.1. Resistance Training. For the RT program, both a
Keiser Pressurized Air system and free weights were used
[]. e Keiser-based exercises consisted of biceps curls,
triceps extension, seated row, latissimus dorsi pull downs,
leg press, hamstring curls, and calf raises. e intensity of
the training stimulus was at a work range of six to eight
repetitions (two sets). e training stimulus was subsequently
increased using the RM method—when two sets of six
to eight repetitions were completed with proper form and
without discomfort. Other key strength exercises included
minisquats, minilunges, and lunge walks.
2.9.2. Aerobic Training. e AT program was an outdoor
walking program. e intensity of the training stimulus was
at approximately % of ones age specic target heart rate
(i.e., heart rate reserve; HRR) and progressed over the rst 
weeks to the range of % to % of HRR. Exercise intensity
was monitored through heart rate monitors. Participants also
monitored the intensity of their workouts by the Borg’s Rating
of Perceived Exertion [] and the “talk” test [,].
2.9.3. Balance and Tone. e BAT program consisted of
stretching exercises, range of motion exercises, balance exer-
cises, functional sand relaxation techniques []. Other than
bodyweight, no additional loading (e.g., hand weights, etc.)
was applied. is group served to control for confounding
variables such as physical training received by traveling to the
training centres, social interaction, and changes in lifestyle
secondary to study participation.
2.10. Adverse Eects. Participants were questioned about the
presence of any adverse eects, such as musculoskeletal pain
or discomfort, at each exercise session. Instructors monitored
participants for symptoms of angina and shortness of breath
during the exercise classes.
2.11. Statistical Analysis. All analyses were “full analysis set”
[] (dened as the analysis set which is as complete and as
close as possible to the intention-to-treat ideal of including
all randomized participants). Data were analyzed using IBM
Performance on the RAVLT was measured using univari-
ate ANOVAs for each outcome measure, with two planned
simple contrasts to assess dierences between () RT versus
BAT and () AT versus BAT. Baseline scores were entered as
covariates. For the spatial memory task, repeated measures
ANOVAs were performed to examine changes over the
course of the trial in both reaction time and accuracy,
with number of items (one, two, or three) as the within-
subjects factor and group as the between-subjects factor. e
reaction time analysis included choice reaction time as a
covariate to account for dierences in processing speed [].
Bivariate Pearson correlations were calculated to examine
the relationship between memory and physical performance
Change in loss aer interference (trial completion baseline)
F : Change between baseline and trial completion in loss
aer interference on the RAVLT as a function of exercise group. e
AT group showed signicantly more change compared to the BAT
group. Error bars represent standard error of the mean.
at trial completion within each group. For all analyses the
overall alpha was set at 𝑃 ≤ 0.05.
3. Results
3.1. Descriptive Variables, Physical Activity, and Participants.
In this trial,  participants were recruited and randomized
(Figure ). Baseline demographic and characteristics of the
 participants are shown in Table  .Physicalactivitylevels
(PASE scores) did not dier signicantly between the groups
at midpoint (𝑃 = 0.93)ortrialcompletion(𝑃 = 0.67). Of the
 participants,  completed the -week trial. e number
of dropouts was the greatest in the AT group (Figure ).
3.2. Verbal Memory and Learning. Ta b l e shows the baseline,
mid-point, and trial completion results for verbal memory
signicant between-group dierences at trial completion in
recall (all P’s >.). However, there was a signicant dif-
ference in loss aer interference at trial completion between
theATandBATgroups,𝑃 = 0.04 (Figure ). Conversely,
the RT and BAT contrast for loss aer interference was
nonsignicant, 𝑃 = 0.20.Overall,lossaerinterferencewas
group, respectively. In contrast, the BAT group demonstrated
a .% increase in loss aer interference. e improvement
observed in the AT group was not present at mid-point, 𝑃=
3.3. Spatial Memory. Ta b l e  shows the baseline, mid-point,
and trial completion results for reaction time and accuracy
Journal of Aging Research
T : Mean values (SDs) for RAVLT p e r f o r m a n c e .
Variabl e Baseline Midpoint Final
Mean (SD) Mean (SD) Mean (SD)
RT 𝑛 = 25 𝑛 = 24 𝑛 = 25
Total acquisition . (.) . (.) . (.)
Recall aer interference . (.) . (.) . (.)
Loss aer interference . (.) . (.) . (.)
Long delay free recall . (.) . (.) . (.)
AT 𝑛 = 24 𝑛 = 23 𝑛 = 24
Total acquisition . (.) . (.) . (.)
Recall aer interference . (.) . (.) . (.)
Loss aer interference . (.) . (.) . (.)
Long delay free recall . (.) . (.) . (.)
BAT 𝑛 = 25 𝑛 = 24 𝑛 = 25
Total acquisition . (.) . (.) . (.)
Recall aer interference . (.) . (.) . (.)
Loss aer interference . (.) . (.) . (.)
Long delay free recall . (.) . (.) . (.)
Abbreviations: BAT: balance and tone; AT: aerobic training; RT: resistance training.
Change in reaction time
One item Two items ree items
(trial completion minus baseline)
F : Change between baseline and trial completion on the
spatial memory task as a function of number of items presented
and exercise group. Both the RT and AT groups showed improved
performance compared to the BAT group for the memorization of
three items. Error bars represent standard error of the mean.
on the spatial memory task. e exercise groups diered
in reaction time changes aer completion of the trial as a
function of number of items to be remembered. is was
evidenced by a signicant item by group interaction, F(,)
= ., 𝑃 = 0.05.Examiningtheplots(Figure ), the RT and
AT groups appear to have improved their reaction times for
memorizing the spatial location of three items more than the
BAT group. Notably, this between-groups dierence was not
present at mid-point, 𝑃 = 0.18. ere were no signicant
dierences between the exercise groups in accuracy for
400 300 200 100
SPPB score at trial completion
minus baseline
ree item reaction time at trial completion minus baseline
Aerobic training group
F : Signicant correlations between change in reaction time
performance on the spatial memory task and change in performance
on the SPPB for the AT group. SPPB performance was negatively
correlated with spatial memory reaction time, where better balance
and mobility were associated with faster reaction times.
spatial memory for either mid-point or trial completion (𝑃=
0.83 and ., resp.).
3.4. Correlations between Memory and Physical Performance.
Changes in physical performance as a function of exercise
group have been previously reported []. In this study,
faster reaction times at trial completion compared to baseline
during the three-item condition on the spatial memory task
were associated with better performance on the SPPB in the
AT gr oup ( Figure ). is was conrmed via a signicant neg-
ative correlation between the two variables, 𝑟(13) = −0.57,
𝑃 = 0.04. Spatial memory reaction times and SPPB were
not signicantly correlated in the RT or BAT groups (𝑃=
0.20 and ., resp.). Furthermore, reaction times were not
associated with performance on the Six-Minute Walk Test
(all P’s >.). ere were no signicant correlations between
Journal of Aging Research
T : Mean values (SDs) for spatial memory performance.
Variabl e Baseline Midpoint Final
Mean (SD) Mean (SD) Mean (SD)
RT 𝑛=19 𝑛=18 𝑛=19
Reaction time, ms
One item . (.) . (.) . (.)
Two items . (.) . (.) . (.)
ree items . (.) . (.) . (.)
One item . (.) . (.) . (.)
Two items . (.) . (.) . (.)
ree items . (.) . (.) . (.)
Choice reaction time, ms . (.) . (.) . (.)
AT 𝑛=17 𝑛=16 𝑛=17
Reaction time, ms
One item . (.) . (.) . (.)
Two items . (.) . (.) . (.)
ree items . (.) . (.) . (.)
One item . (.) . (.) . (.)
Two items . (.) . (.) . (.)
ree items . (.) . (.) . (.)
Choice reaction time, ms . (.) . (.) . (.)
BAT 𝑛=19 𝑛=19 𝑛=19
Reaction time, ms
One item . (.) . (.) . (.)
Two items . (.) . (.) . (.)
ree items . (.) . (.) . (.)
One item . (.) . (.) . (.)
Two items . (.) . (.) . (.)
ree items . (.) . (.) . (.)
Choice reaction time, ms . (.) . (.) . (.)
Abbreviations: BAT: balance and tone; AT: aerobic training; RT: resistance training.
aMaximum was ..
RAVLT performance and either of the physical performance
measures (all P’s >.).
3.5. Adverse Events. Adverse eects included episodes of
shortness of breath that resolved with rest (𝑛=2)and
noninjurous falls (𝑛=4).ResultsoftheChiSquaretest
indicated no signicant between-group dierences (𝑃=
0.54) in the proportion of participants reporting adverse
4. Discussion
We analyzed our secondary data from a six-month inter-
vention to examine the eects of aerobic training and
resistance training on two distinct forms of memory. Our
specic aims were to evaluate whether either type of exercise
would improve verbal memory and learning and/or spatial
memory and to determine whether an association might exist
between postintervention memory performance and physical
measures. In this regard, we report three key ndings.
First, we found that twice-weekly aerobic training for six
months remembered signicantly more items in the loss aer
interference condition on the verbal memory test. Second,
our results suggest that both types of exercise improved
reaction times during the spatial memory test compared to
the control group. Last, spatial memory performance appears
to be positively associated with physical performance in the
aerobic training group aer the intervention. e results
of our present study extend those from our previous work
[], where we found that resistance training signicantly
improved associative memory. Within this context, several
noteworthy points of discussion follow.
To begin with, our nding that aerobic exercise signi-
cantly improved verbal memory and learning is consistent
with previous reports. Specically, Pereira and colleagues
Journal of Aging Research
[] found that three months of aerobic exercise improved
performance on the RAVLT. While the benets of aerobic
activity on verbal memory and learning in our study were
only observed aer six months—compared to three months
in the study by Pereira et al. [], dierences in study design
may account for this apparent discrepancy. For example,
participants in the study by Pereira et al. []wereyoung,
healthy adults who engaged in aerobic activity four times per
were already experiencing cognitive decline and exercised
twice per week. is suggests that a higher dose of exercise
may result in observable changes in memory more quickly.
It is worth mentioning that in our study, the resistance
training group also showed a greater reduction in loss aer
interference aer the trial compared with the control group,
although this change was not signicant. Nevertheless, future
studies with larger sample sizes may discover that resistance
training does yield similar benets to aerobic training for
verbal memory performance.
Second, we found that both of our experimental exercise
groups showed improved reaction time performance for
recalling the spatial location of three items, as compared to
the balance and tone group. Task performance on the spatial
memory test has been shown to systematically decline as a
function of load []. at the between-group dierence was
solely observed for three items—the most dicult condition
for the spatial memory task—suggests that exercise distinc-
tively improves higher-level cognitive processing required for
from previous studies, where both resistance and aerobic
training improved executive functioning—such as selective
attention and conict resolution, as measured by the Stroop
task [,,].
ird, in light of our initial ndings regarding improved
associative memory performance aer six months of twice-
weekly resistance training, the results of our present study
suggest that dierent types of exercise may selectively target
distinct cognitive processes—and their underlying neural
correlates. To recapitulate, we previously reported that resis-
tance training resulted in improved associative memory
performance and increased functional activation in three
key regions of the cortex: the right lingual and occipital-
fusiform gyri and the right frontal pole []. In contrast,
here we found that both types of exercise training led to
im prov ed spat i a l m emory. Imp ortant l y, spatia l m e mory has
neural underpinnings in the hippocampus [,], thus
suggesting that both forms of exercise training may impact
hippocampal structure and/or function. Indeed, it has been
established that the hippocampus is the structure most
sensitive to exercise-induced change via neurogenesis and
cell proliferation. For example, aerobic exercise has been
found to increase hippocampal volume and levels of BDNF—
a neurotrophic factor involved in cell growth and survival
and memory promotion [].us,whiletherearemultiple
potential mechanisms to account for the relationship between
cognitive functions and physical activity, such as increased
cerebral blood ow [], reduced neuroinammation [],
and contribution of white matter hyperintensities [], we can
speculate that underlying changes in hippocampal structure
and/or function may be a mediating observed relationship
between spatial memory and physical performance.
Finally, the link between physical activity and cognitive
functioning is further supported by the signicant corre-
lation we have reported between our measure of overall
physical performance and spatial memory in the aerobic
training group. Notably, these results correspond to our
previous ndings that improvements in conict resolution
and selective attention, as measured by Stroop performance,
were signicantly correlated to improved gait speed aer
 months of resistance training []. at these two studies
found relationships between dierent types of exercise (aer-
obic versus resistance training) and two dierent measures
of cognitive function further supports the notion presented
ular pathways []—and thus, modify dierent subtypes
of cognitive function. However, in combination, evidence
from these two studies demonstrate that higher levels of
physical performance are associated with better cognitive
performance. Given that there are multiple ways to improve
general physical performance levels, our results therefore
suggest that individuals may gain cognitive benets from a
wide variety of exercise options. Future work is needed to
explore this possibility.
e conclusions of our study are tempered by our exclu-
sion of men and those older or younger than – years
old. Additionally, our study was only powered to compare the
resistance training versus the control group and the aerobic
training versus the control group; therefore, we were unable
to directly compare changes in performance between our two
exercise groups. Hence, future research on how our results
may apply to the broader population with larger sample sizes
is warranted.
In sum, our study provides preliminary evidence that
multiple benets for memory can be observed aer six
months of exercise training. However, the mechanisms
behind how resistance training and aerobic training may dif-
ferentially impact cognition remain unclear; thus future work
should be aimed at further understanding the contribution
of each type of exercise to cognitive functioning, functional
plasticity, and brain structure. Furthermore, while our study
did nd performance improvements aer six months, we did
not see comparable changes aer only three months using a
twice-weekly exercise protocol. erefore, the dose-response
relationship of exercise needs to be elucidated so that future
recommendations for the most eective program can be
translated to health care practitioners and the public.
T. L. Ambrose had full access to all the data in the study
and takes responsibility for the integrity of the data and the
accuracy of the data analysis.
Conflict of Interest
All authors have no conict of interests to declare.
Journal of Aging Research
e Pacic Alzheimer’s Research Foundation provided fund-
ing for this study (to T. L. Ambrose). e authors thank the
instructors for their commitment to the participants’ health
and safety. T. L. Ambrose is a Michael Smith Foundation
for Health Research Scholar and a Canada Research Chair
in Physical Activity, Mobility, and Cognitive Neuroscience.
L. Nagamatsu is a Michael Smith Foundation for Health
Research Senior Graduate trainee and a Natural Sciences and
Engineering Research Council of Canada Doctoral trainee.
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... The studies were published in Canada, America, the Netherlands, and China between 2008 and 2021. The participants were recruited from communities, hospitals, clinics, or elderly care centers [32][33][34][35][36][37][38][39][40][41][42][43][44][45]. The sample size of these studies ranged from 21 to 138. ...
... Three studies reported the effects of walking on verbal learning in individuals with MCI measured by RAVLT [32][33][34]. The forest plots showed no significant difference between the walking and control groups (n=416, MD=-0.08, ...
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Background Mild cognitive impairment (MCI) is the stage between the expected cognitive decline of normal aging and the more serious decline of dementia. Previous studies have shown that regular exercise can improve cognition and physical performance in older adults. Walking is a low-technology and low-cost exercise that has been proven to improve cognition and mobility in healthy elderly individuals. However, no systematic review or meta-analysis has explored whether walking can improve cognitive function in older adults with MCI. This study aimed to explore the effects of walking interventions on cognitive functions in individuals with MCI. Methods In accordance with the PRISMA guidelines, MEDLINE, PubMed, SPORTDiscus, Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, Airiti Library, and the National Digital Library of Theses and Dissertations in Taiwan were searched from inception to July 2023. Independent reviewers selected randomized clinical trials (RCT) that compared the effects of walking with no intervention or other exercises in individuals with MCI. The primary outcomes were cognitive functions, and the secondary outcome was walking endurance. Three reviewers independently conducted data extraction. The risk of bias was assessed using the Revised Cochrane Risk of Bias assessment tool. Results Fourteen RCTs were included in this review. The quality of evidence in these studies was rated as good to excellent. The results of the meta-analysis showed that the individuals with MCI had no significant improvement in cognitive function but had significant improvement in the 6-min walk test (Mean Difference=23.70, p=0.008) after walking interventions compared to no intervention or other exercises. Conclusion Walking intervention has no significant improvement on cognitive functions in older adults with MCI. However, walking induces beneficial effects on aerobic capacity. Trial registration This systematic review has the registration number CRD42021283753 on PROSPERO.
... The walking training will require subjects to walk 120-140 steps per minute, have a heart rate of 55-75% of their maximum heart rate (206.9 − 0.67*age), meet the requirements of moderate exercise intensity, and feel relaxed or free of dizziness, nausea, and fatigue [20,29]. ...
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Background Falls are a global public problem and may be an important cause of death in older adults. However, older adults with mild cognitive impairment(MCI) are more likely to fall and suffer more damage than older adults with normal cognitive function, which shows the importance of preventing falls. More and more evidence shows that Baduanjin can improve the balance function of the elderly and reduce the risk of falls in the elderly with MCI, but the mechanism is still unclear. The main purpose of this study is to verify the intervention effect of Baduanjin training on the risk of falls in elderly people with MCI and to elucidate the underlying mechanism of Baduanjin training in reducing the risk of falls in MCI patients. Methods In this prospective study, outcome assessor-blind, three-arm randomized controlled trial, a total of 72 eligible participants will be randomly allocated (1:1:1) into the 12-week Baduanjin exercise intervention (60 min per session, three sessions per week), the 12-week brisk walking group(60 min per session, three sessions per week) or the 12-week health education group. Primary outcome is the Fall-Risk Self-Assessment Questionnaire(FRQ), and secondary outcomes are fall efficacy index, gait assessment, balance function, lower limb muscle strength, cognitive function, activities of daily living(ADL) and MRI scans. In addition to the MRI scans, which will be measured before and after the intervention,other primary and secondary outcomes will be assessed at baseline, 6 weeks, and 12 weeks (at the end of the intervention) and after an additional 12-week follow-up period. The mixed linear model will be conducted to observe the intervention effects. Discussion This trial will investigate the effect of Baduanjin exercise on the prevention of falls in elderly individuals with MCI, explore the imaging mechanism of Baduanjin exercise to reduce the risk of falls in elderly individuals with MCI from the perspective of vestibular neural network, and provide strong evidence for Baduanjin exercise to reduce the risk of falls in elderly individuals with MCI, as well as provide new ideas and approaches for the central mechanism of Traditional Chinese Medicine(TRC) rehabilitation methods to intervene in falls in elderly. Trial registration, ID: ChiCTR2200057520. Registered on 14 March 2022,
... Physical activity in older persons has a wide range of advantages, including delaying frailty, improving cognitive function, enhancing overall functioning, reducing cognitive decline, improving memory, promoting self-reported health, reducing mortality risk, impacting neurodegenerative indicators positively, and contributing to successful aging. [29][30][31][32][33][34][35][36][37][38] Regular physical activity, including exercise, is essential for maintaining physical, mental, and emotional well-being, particularly for older individuals. It has been shown to prevent and manage age-related health problems, chronic diseases, and reduce the risk of various health conditions. ...
This review examines the impact of physical activity, nutrition, and sleep evaluations on the physical wellness (PW) and overall well-being of older individuals. A comprehensive search was conducted in databases like PubMed, Google Scholar, and EBSCO Information Services. The search spanned from January 2000 to December 2022, resulting in 19,400 articles, out of which 98 review articles met the inclusion criteria. Through the analysis of these articles, key characteristics of the literature were summarized, and opportunities to enhance the practical application of physical activity (PA), nutrition, and sleep evaluations in the daily lives of older persons were identified. Regular physical activity is crucial for older persons to maintain their physical, mental, and emotional well-being and prevent age-related health issues. Older persons have specific nutritional needs, including increased protein, vitamin D, calcium, and vitamin B12 intake. Poor sleep quality in older persons is associated with negative health outcomes such as cognitive decline, physical disability, and mortality. This review emphasizes the significance of considering physical wellness as a fundamental element for achieving holistic well-being in older persons and highlights the importance of physical activity, nutrition, and sleep evaluations in improving their overall health and well-being. By understanding and implementing these findings, we can enhance the quality of life and promote healthy aging in older persons.
... Considering the vestibular system is more diffusely projected to a variety of cortical and subcortical areas than any other system, as well as a special and important vestibular pathway that seems to originate mainly from the semicircular canals and terminated in the medial temporal cortex, including the hippocampal and parahippocampal gyrus [21,66], we expected the use of Cawthorne-Cooksey exercises as a vestibular intervention improved memory performance in patients with aMCI. The hippocampus is highly sensitive to exercise-induced changes through neurogenesis and cell proliferation [67]. Physical exercises, of which VR is a part, reduce neuroinflammation and oxidative stress, increase the expression of BDNF (a brain-derived neurotrophic factor that plays a role in cell growth, survival, and memory enhancement), increase the level of calcium messenger RNA, improving transmission speed, and stimulating neuroplasticity [68][69][70]. ...
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Background and Aim: Considering the critical input of the vestibular system to the hippocampus as an area involved in cognition, and vestibular disorders reported in patients with amnestic Mild Cognitive Impairment (aMCI), we aimed to investigate the effects of Vestibular Rehabilitation (VR) with and without noisy Galvanic Vestibular Stimulation (nGVS) on cognitive function in patients with aMCI. Methods: In a randomized controlled trial, twenty-two patients with aMCI were randomly assigned to two groups receiving: 1) VR for four weeks (VR group); 2) VR for four weeks with nGVS for three sessions (GVS+VR group). Outcome measures were Rey's Auditory-Verbal Learning Test (RAVLT), Corsi blocks, Visual Search (VS), and match to sample tests. Results: Mean immediate and delayed recalls of RAVLT, all of the outcomes of Corsi blocks and VS tests, and the error rate of the match to sample tests improved significantly after intervention in VR and GVS+VR groups. Between-group differences were observed for learning and delayed recalls of RAVLT (p=0.001, d=0.444 and p
... Unfortunately, no studies have directly studied this topic; however, this link between sarcopenia and memory function has been implied by the association between physical activity and memory-specific function. In 2009, a 6-month randomized controlled trial study among women aged 70-80 years in Canada concluded that the regular physical activity group remembered significantly more items in the verbal memory test (p = 0.04) and that there was a significant correlation between spatial memory performance and overall physical capacity after intervention in the aerobic training group [36]. In another study that used magnetic resonance imaging in 165 non-dementia older adults, aerobic fitness was related to larger hippocampal volume and better spatial memory performance [37]. ...
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Background A link between sarcopenia and cognitive function has been proposed and is supported by several investigations. Nevertheless, the sex-linked relationship between these two diseases has been scarcely investigated. This cross-sectional study investigated sex differences in the association between sarcopenia and mild cognitive impairment. Methods We included all 286 participants aged 60 years or older with MCI who visited the Department of Neurology at Veterans Health Service Medical Center in South Korea from January to December 2021. The diagnosis of MCI was confirmed by two neurologists based on the participants’ neuropsychological test scores. Diagnosis of sarcopenia was based on the algorithm of Asian Working Group for Sarcopenia (AWGS) 2019 including bioelectrical impedance analysis and handgrip strength, and cognitive function was assessed using Seoul Neuropsychological Screening Battery Core (SNSB-C) test. Results Among the 286 participants, 171 and 112 were men and women. After adjustment for potential covariates including APOE genotype, in women participants, there were significant associations between diagnosis of sarcopenia and MCI (OR = 4.72, 95%CI [1.39–15.97]), while there was no significant relationship in men participants. In eight subdomains of SNSB-C, we also found that women participants with sarcopenia demonstrated a significant memory decline (OR = 3.21, 95%CI [1.01–10.19]) as compared with the reference women group without sarcopenia after adjusting all covariates mentioned above. No significant association between any SNSB-C subdomain and MCI was demonstrated in men participants. Conclusions We demonstrated that there was a different relationship between sarcopenia and MCI by sex and that sarcopenia may affect the cognitive subdomain differently by sex. These results imply that, with regard to cognitive function, maintaining muscle function and muscle mass might be more crucial for women than for men.
... 33,51 On the other hand, one study reported an attendance rate (33%) that is lower than that of ours. 52 Regarding attrition, our study had a low drop-out rate of 4% (only 2 out of the 53 participants dropped out), which is lower than some of the prior interventions, such as one reporting the drop-out rate of 36%. 53 Our relatively high attendance and low drop-out rate can be attributed to numerous factors, including having trained research assistants monitoring and correcting participants' movements, setting a recurring exercise time and implementing sessions consistently, and creating a Table 3 Baseline mean (SD) of key health outcomes and adjusted results of GLMs between age groups <80 and 80. Model adjusted for gender, marital status, education level, number of children, and cognitive performances. ...
Background: Culturally tailored group exercise bridges health disparities among new immigrants, particularly older adults. We designed a Chinese Qigong (Baduanjin) exercise intervention testing the feasibility and acceptability among older Chinese at a senior daycare center in Philadelphia, PA, US. Methods: 10-week Qigong group in-person exercise was delivered 5 days a week, using a 12-minute video tutorial under trained research assistants' guidance. Daily attendance and attrition was recorded. Participants completed baseline self-report assessments on physical and mental health, and two computerized cognitive tests, the psychomotor vigilance test and a memory test. Results: 53 older adults participated (mean age: 78, female: 88.7%). Average daily attendance was 65.28%. Stratification analysis on age groups <80 and ≥80 shows no significant differences on key variables. Conclusions: Recruitment for Baduanjin Qigong exercise was feasible in senior daycare centers, and older adults could easily learn and safely follow exercise movements. Preliminarily findings call for further research.
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O presente estudo buscou verificar o efeito de 16 semanas de exercícios multimodais na capacidade funcional e cognitiva em idosos comunitários do município de Tocantinópolis-TO. A pesquisa teve caráter descritivo, longitudinal e quase-experimental. Participaram deste estudo 44 idosos, sendo 20 do sexo masculino, com média de idade de 69 ± 7,3 anos e 24 do sexo feminino, com média de idade de 66 ± 7,6 anos. A seleção dos participantes foi realizada por meio da técnica de amostragem por conveniência em utentes da Academia da Melhor Idade (AMI), em Tocantinópolis-TO. Antes e após as 16 semanas de intervenção com exercícios multimodais, foram aplicadas: a bateria Senior fitness test de Rikli & Jones (2013) e avaliação do estado cognitivo com o Mini Exame de Estado Mental (MEEM). Em relação às variáveis da capacidade funcional, apenas o teste de “Caminhada de 6 minutos” apresentou diferença significativa nos participantes do sexo masculino (C6Min pré = 516,2 metros vs. pós = 545,8 metros; p < 0,05). Nas mulheres foram observadas diferenças significativas nas variáveis “Levantar e Sentar da Cadeira” (LSC pré = 12,5 repetições vs. Pós = 14,1 repetições; p < 0,05), “Sentado, Caminhar 2,44 m e sentar” (SCS pré = 7,3 segundos vs. pós = 6,8 segundos; p < 0,05) e “Caminhada de 6 minutos” (C6Min pré = 483,1 m vs. pós = 514,1 m; p < 0,05). O nível de cognição apresentou diferença significativa após 16 semanas de intervenção em relação aos valores verificados no baseline, tanto para os homens (MEEM pré = 21,2 vs. pós = 23,9; p < 0,05), quanto para as mulheres (MEEM pré = 23,9 pontos vs. pós = 25,1 pontos; p < 0,05). Conclui-se que os exercícios multimodais foram efetivos na melhora da cognição em e em determinadas variáveis relacionadas à capacidade funcional nos idosos após 16 semanas de intervenção.
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Introduction: There is a large interindividual variability in cognitive functioning with increasing age due to biological and lifestyle factors. One of the most important lifestyle factors is the level of physical fitness (PF). The link between PF and brain activity is widely accepted but the specificity of cognitive functions affected by physical fitness across the adult lifespan is less understood. The present study aims to clarify whether PF is basically related to cognition and general intelligence in healthy adults, and whether higher levels of PF are associated with better performance in the same or different cognitive functions at different ages. Methods: A sample of 490 participants (20-70 years) was analyzed to examine this relationship. Later, the sample was split half into the young to middle-aged group (YM; 20-45 years; n = 254), and the middleaged to older group (MO; 46-70 years; n = 236). PF was measured by a quotient of maximum power in a bicycle ergometry test PWC-130 divided by body weight (W/kg), which was supported by a self-reported level of PF. Cognitive performance was evaluated by standardized neuropsychological test batteries. Results: Regression models showed a relationship between PF and general intelligence (g-factor) and its subcomponents extracted using structural equation modeling (SEM) in the entire sample. This association was moderated by age, which also moderated some specific cognitive domains such as attention, logical reasoning, and interference processing. After splitting the sample into two age groups, a significant relationship was found between cognitive status, as assessed by the Mini Mental State Examination (MMSE), and PF in both age groups. However, apart from cognitive failures in daily life (CFQ), no other association between PF and specific cognitive functions was found in the YM group. In contrast, several positive associations were observed in the MO group, such as with selective attention, verbal memory, working memory, logical reasoning, and interference processing. Discussion: These findings show that middle-aged to older adults benefit more from PF than younger to middle-aged adults. The results are discussed in terms of the neurobiological mechanisms underlying the cognitive effects of PF across the lifespan. Clinical trial registration:, identifier NCT05155397.
The chapter analyses the relationship between cognitive development and physical fitness in the first year of compulsory education using evidence from the iPIPS project in Brazil.KeywordsEarly childhoodCognitionMotor skillsLongitudinal study
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Current evidence showed that heavy metal exposure including cadmium (Cd) exposure might contribute to memory function impairment in youth, while this association has not been extensively explored in senior groups. Complementary therapy like physical activity (PA) is proved to enhance memory; however, the combined effects of Cd exposure and PA are interesting issues worth investigating. Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 were analyzed. Multivariable weighted linear regression model and restricted cubic splines analysis were used to examine the association between blood Cd, PA, and memory function. Ultimately, 1884 samples were analyzed, and the weighted participants were 98,350,183. Results showed that in the immediate and delayed recall tests, a negative association was found between blood Cd and scores for the fully adjusted model, while a positive association was detected with PA on memory test scores. In subgroup analysis, for the delayed recall test, in lower Cd exposure (Cd = Q1), stronger effect size was found in the moderate level PA group than the higher level PA group (moderate level PA group, β = 1.133, 95% CI: 0.330, 1.936; high level PA group, β = 0.203, 95% CI: − 0.314, 0.719), and this finding also existed in higher (Cd = Q4) exposure (moderate level PA group, β = 0.988, 95% CI: 0.267, 1.708; high level PA group, β = 0.830, 95% CI: 0.261, 1.400). Moreover, the non-linear relationship between Cd exposure and performance of CERAD test under different levels of PA was reported, and the moderate level PA group performed best from lower to higher blood Cd. According to our research, the benefit of PA did not always expand with the PA intensity increment under different Cd exposure. Performing an appropriate level of physical exercise could alleviate the memory decline under Cd exposure in the elder groups. Further biological investigations are warranted to verify these findings. Graphical Abstract
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Background: Our goal was to forecast the global burden of Alzheimer’s disease and evaluate the potential impact of interventions that delay disease onset or progression. Methods: A stochastic, multistate model was used in conjunction with United Nations worldwide population forecasts and data from epidemiological studies of the risks of Alzheimer’s disease. Results: In 2006, the worldwide prevalence of Alzheimer’s disease was 26.6 million. By 2050, the prevalence will quadruple, by which time 1 in 85 persons worldwide will be living with the disease. We estimate about 43% of prevalent cases need a high level of care, equivalent to that of a nursing home. If interventions could delay both disease onset and progression by a modest 1 year, there would be nearly 9.2 million fewer cases of the disease in 2050, with nearly the entire decline attributable to decreases in persons needing a high level of care. Conclusions: We face a looming global epidemic of Alzheimer’s disease as the world’s population ages. Modest advances in therapeutic and preventive strategies that lead to even small delays in the onset and progression of Alzheimer’s disease can significantly reduce the global burden of this disease.
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Objectives: To investigate the effect of 2 standardized exercise programs, muscle strength exercises (SE) and aerobic exercises (AE), on the plasma levels of brain-derived neurotrophic factor (BDNF) and depressive symptoms in 451 elderly women. Design: A randomized controlled trial. Setting: Belo Horizonte/MG-Brazil. Participants: Community-dwelling older women (N=451; age, 65-89y). Intervention: The participants were divided into 2 groups: SE and AE. Both protocols lasted 10 weeks, and 30 sessions (1-h sessions) in total were performed 3 times a week under the direct supervision of physical therapists. Main outcome measures: Plasma levels of BDNF (enzyme-linked immunosorbent assay) and depressive symptoms (Geriatric Depression Scale). Results: There was a significant difference for BDNF plasma levels between the SE and AE groups (P=.009). Post hoc analysis revealed a pre-post intervention difference in BDNF levels only for the SE group (P=.008). A statistically significant difference was found for the pre- and postintervention Geriatric Depression Scale scores in both groups (P=.001), showing that the effects of both exercise protocols were comparable regarding depressive symptoms (P=.185). Conclusions: The present findings have demonstrated the positive effect of muscle strengthening and aerobic intervention on depressive symptoms in community-dwelling elderly women. Interestingly, only SE significantly increased the plasma levels of BDNF in our sample. The positive effects of physical exercise on depressive symptoms in the elderly were not mediated by BDNF.
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Background Older adults free of dementia but with subjective memory complaints (SMC) or mild cognitive impairment (MCI) are considered at increased risk of cognitive decline. Vascular risk factors (VRF), including hypertension, heart disease, smoking, hypercholesterolemia and lack of physical activity (PA) have been identified as modifiable risk factors contributing to cognitive decline, and white matter hyperintensities (WMH) are associated with VRF, SMC and cognitive impairment. Findings from a growing number of clinical trials with older adults are providing strong evidence for the benefits of physical activity for maintaining cognitive function, but few studies are investigating these benefits in high-risk populations. The aim of AIBL Active is to determine whether a 24-month physical activity program can delay the progression of white matter changes on magnetic resonance imaging (MRI). Methods/design This single-blind randomized controlled trial (RCT) is offered to 156 participants, aged 60 and older, in the Melbourne arm of the Australian Imaging Biomarkers and Lifestyle Flagship Study of Aging (AIBL). Participants must have SMC with or without MCI and at least one VRF. The PA intervention is a modification of the intervention previously trialed in older adults with SMC and MCI (Fitness for the Ageing Brain Study). It comprises 24 months of moderate, home-based PA (150 minutes per week) and a behavioral intervention package. The primary outcome measure will be change in WMH after 24 months on MRI. Cognition, quality of life, functional fitness, level of physical activity, plasma biomarkers for cerebrovascular disease and amyloid positron emission tomography (PET) imaging comprise secondary measures. Discussion Currently, there is no effective pharmacological treatment available to delay cognitive decline and dementia in older adults at risk. Should our findings show that physical activity can slow down the progression of WMH, this RCT would provide an important proof of concept. Since imbedded in AIBL this RCT will also be able to investigate the interaction between vascular and Alzheimer's disease pathologies. Trial Registration Australia New Zealand Clinical Trials Registry ACTRN12611000612910
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Correspondence: Dr Liu-Ambrose, Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada ( Author Contributions: All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Voss and Liu-Ambrose. Acquisition of data: Nagamatsu, Hsu, and Liu-Ambrose. Analysis and interpretation of data: Nagamatsu, Handy, Voss, and Liu-Ambrose. Drafting of the manuscript: Nagamatsu, Handy, and Liu-Ambrose. Critical revision of the manuscript for important intellectual content: Nagamatsu, Handy, Hsu, Voss, and Liu-Ambrose. Statistical analysis: Nagamatsu, Voss, and Liu-Ambrose. Obtained funding: Liu-Ambrose. Administrative, technical, and material support: Nagamatsu, Hsu, Voss, and Liu-Ambrose. Study supervision: Handy and Liu-Ambrose. Financial Disclosure: None reported. Funding/Support: The Pacific Alzheimer's Research Foundation provided funding for this study (Dr Liu-Ambrose). Previous Presentation: Data from this manuscript were presented as a podium presentation at the International Society for Neuroimaging in Psychiatry; September 9, 2011; Heidelberg, Germany. Additional Information: Ms Nagamatsu is a Michael Smith Foundation for Health Research Senior Graduate trainee and a Natural Sciences and Engineering Research Council of Canada Doctoral trainee. Dr Liu-Ambrose is a Michael Smith Foundation for Health Research Scholar, a Canadian Institutes of Health Research New Investigator, and a Heart and Stroke Foundation of Canada's Henry J. M. Barnett's Scholarship recipient. Additional Contributions: Alison Chan, BSc, Jennifer C. Davis, PhD, B. Lynn Beattie, MD, and Peter Graf, PhD, made significant contributions to this study. We thank the instructors for their commitment to the participants' health and safety. This article was corrected for errors on July 10, 2013.
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A growing body of scientific evidence indicates that exercise has a positive impact on human health, including neurological health. Aerobic exercise, which is supposed to enhance cardiovascular functions and metabolism, also induces neurotrophic factors that affect hippocampal neurons, thereby improving spatial learning and memory. Alternatively, little is known about the effect of resistance exercise on hippocampus-dependent memory, although this type of exercise is increasingly recommended to improve muscle strength and bone density and to prevent age-related disabilities. Therefore, we evaluated the effects of resistance training on spatial memory and the signaling pathways of brain-derived neurotrophic factor (BDNF) and insulin-like growth factor 1 (IGF-1), comparing these effects with those of aerobic exercise. Adult male Wistar rats underwent 8 weeks of aerobic training on a treadmill (AERO group) or resistance training on a vertical ladder (RES group). Control and sham groups were also included. After the training period, both AERO and RES groups showed improved learning and spatial memory in a similar manner. However, both groups presented distinct signaling pathways. Although the AERO group showed increased level of IGF-1, BDNF, TrkB, and β-CaMKII (calcium/calmodulin-dependent kinase II) in the hippocampus, the RES group showed an induction of peripheral and hippocampal IGF-1 with concomitant activation of receptor for IGF-1 (IGF-1R) and AKT in the hippocampus. These distinct pathways culminated in an increase of synapsin 1 and synaptophysin expression in both groups. These findings demonstrated that both aerobic and resistance exercise can employ divergent molecular mechanisms but achieve similar results on learning and spatial memory.
01-02-02 The goal was to forecast the global burden of Alzheimer’s disease and evaluate the potential impact of interventions that delay disease onset or progression.
Background: Cognitive decline among seniors is a pressing health care issue. Specific exercise training may combat cognitive decline. We compared the effect of once-weekly and twice-weekly resistance training with that of twice-weekly balance and tone exercise training on the performance of executive cognitive functions in senior women. Methods: In this single-blinded randomized trial, 155 community-dwelling women aged 65 to 75 years living in Vancouver were randomly allocated to once-weekly (n = 54) or twice-weekly (n = 52) resistance training or twice-weekly balance and tone training (control group) (n = 49). The primary outcome measure was performance on the Stroop test, an executive cognitive test of selective attention and conflict resolution. Secondary outcomes of executive cognitive functions included set shifting as measured by the Trail Making Tests (parts A and B) and working memory as assessed by verbal digit span forward and backward tests. Gait speed, muscular function, and whole-brain volume were also secondary outcome measures. Results: Both resistance training groups significantly improved their performance on the Stroop test compared with those in the balance and tone group (P < .03). Task performance improved by 12.6% and 10.9% in the once-weekly and twice-weekly resistance training groups, respectively; it deteriorated by 0.5% in the balance and tone group. Enhanced selective attention and conflict resolution was significantly associated with increased gait speed. Both resistance training groups demonstrated reductions in whole-brain volume compared with the balance and tone group at the end of the study (P <= .03). Conclusion: Twelve months of once-weekly or twice-weekly resistance training benefited the executive cognitive function of selective attention and conflict resolution among senior women.
Maintaining functional plasticity of the cortex is essential for healthy aging and aerobic exercise may be an effective behavioral intervention to promote functional plasticity among seniors. Whether resistance training has similar benefits on functional plasticity in seniors has received little investigation. Here we show that 12 months of twice-weekly resistance training led to functional changes in 2 regions of cortex previously associated with response inhibition processes-the anterior portion of the left middle temporal gyrus and the left anterior insula extending into lateral orbital frontal cortex-in community-dwelling senior women. These hemodynamic effects co-occurred with improved task performance. Our data suggest that resistance training improved flanker task performance in 2 ways: (1) an increased engagement of response inhibition processes when needed; and (2) a decreased tendency to prepare response inhibition as a default state. However, we highlight that this effect of resistance training was only observed among those who trained twice weekly; participants of the once-weekly resistance training did not demonstrate comparable response profiles, both in behavioral performance and hemodynamic activity in cortex. In sum, our findings suggest that twice-weekly resistance training in seniors can positively impact functional plasticity of response inhibition processes in cortex, and that it does so in a manner that complements the effects on selective attention that have previously been ascribed to aerobic exercise in seniors.