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Alzheimer's & dementia (New York, N. Y.)
2021;7 (1): e12224.

Aerobic exercise in older people with subclinical sporadic cerebral small vessel disease: A randomized clinical trial.

Adrian Wong, Bonnie Yin Ka Lam, Margaret Kit Yi Mak, Linda Chiu Wa Lam, Lisa Wing Chi Au, Brian Ka Fung Yiu, Chun Wong, Hor Yee Tong, Sin Ki Yeung, Winnie Chiu Wing Chu, Lin Shi, Thomas Wai Hong Leung, Yannie Oi Yan Soo, Alexander Yuk Lun Lau, Bonaventure Yiu Ming Ip, Timothy Chi Yui Kwok, Ho Ko, Vincent Chung Tong Mok
Author Information
  1. Adrian Wong: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  2. Bonnie Yin Ka Lam: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  3. Margaret Kit Yi Mak: Department of Rehabilitation Sciences The Hong Kong Polytechnic University Hong Kong SAR China.
  4. Linda Chiu Wa Lam: Department of Psychiatry Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  5. Lisa Wing Chi Au: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  6. Brian Ka Fung Yiu: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  7. Chun Wong: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  8. Hor Yee Tong: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  9. Sin Ki Yeung: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  10. Winnie Chiu Wing Chu: Department of Imaging and Interventional Radiology Faculty of Medicine The Chinese University of Hong Kong Shatin, New Territories Hong Kong SAR China.
  11. Lin Shi: Department of Imaging and Interventional Radiology Faculty of Medicine The Chinese University of Hong Kong Shatin, New Territories Hong Kong SAR China.
  12. Thomas Wai Hong Leung: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  13. Yannie Oi Yan Soo: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  14. Alexander Yuk Lun Lau: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  15. Bonaventure Yiu Ming Ip: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  16. Timothy Chi Yui Kwok: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  17. Ho Ko: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
  18. Vincent Chung Tong Mok: Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
PMID: 35005205 DOI: 10.1002/trc2.12224

Abstract

INTRODUCTION: The benefit and risk of aerobic exercise among older people harboring advanced cerebral small vessel disease (CSVD) upon cognition, mood, and motor functions are unknown.
METHODS: This rater-blind randomized trial examined effects of a 24-week aerobic exercise training (60 min/session, twice/week) upon clinical (cognition, mood, motor functions) and hemodynamic (pulse pressure [PP], blood pressure [BP], pulsatility index) measures in older people harboring moderate to severe CSVD, as evidenced by confluent white matter hyperintensity and/or ≥2 lacunes on magnetic resonance imaging. We further investigated interactions between treatment conditions and hemodynamics measures.
RESULTS: Fifty-three and 54 subjects were randomized into the active and control group, respectively. There was no between-group difference in any of the clinical outcomes. The active group had a greater between-group reduction in systolic BP and PP than the control group. Within-group comparison showed that global cognition of the active group remained similar at end of the study compared to baseline, whereas it declined significantly in the control group. We observed "diverging" interaction effects in that greater reduction in systolic BP/PP was associated with greater improvement in memory functions and global cognition but worsening in processing speed in the active group. Side effects were comparable between the two groups.
DISCUSSION: Future study should investigate the mechanisms of the diverging impacts of aerobic exercise upon different cognitive domains so that the benefit-risk ratio of aerobic exercise in older people harboring more advanced CSVD can be better defined.

Keywords

aerobic exercise cerebral small vessel disease cognitive impairment randomized controlled trial

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Journal Article

Word Cloud

Created with Highcharts 10.0.0exercisegroupaerobicolderpeoplecognitionrandomizedactiveharboringcerebralsmallvesselCSVDuponfunctionstrialeffectsclinicalcontrolgreateradvanceddiseasemoodmotorpressuremeasuresbetween-groupreductionsystolicglobalstudycognitiveINTRODUCTION:benefitriskamongunknownMETHODS:rater-blindexamined24-weektraining60min/sessiontwice/weekhemodynamicpulse[PP]blood[BP]pulsatilityindexmoderatesevereevidencedconfluentwhitematterhyperintensityand/or≥2lacunesmagneticresonanceimaginginvestigatedinteractionstreatmentconditionshemodynamicsRESULTS:Fifty-three54subjectsrespectivelydifferenceoutcomesBPPPWithin-groupcomparisonshowedremainedsimilarendcomparedbaselinewhereasdeclinedsignificantlyobserved"diverging"interactionBP/PPassociatedimprovementmemoryworseningprocessingspeedSidecomparabletwogroupsDISCUSSION:Futureinvestigatemechanismsdivergingimpactsdifferentdomainsbenefit-riskratiocanbetterdefinedAerobicsubclinicalsporadicdisease:impairmentcontrolled

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