Summary: New findings from the EXERT study reveal
that both low and moderate-high intensity exercise may help preserve
cognitive function in older adults with mild memory problems—a major
risk factor for Alzheimer’s disease. Over 12 months, participants who
engaged in either form of exercise showed significantly less cognitive
decline and reduced brain volume loss, especially in the prefrontal
cortex, compared to a usual-care group.
This research highlights
the value of accessible, community-based fitness interventions for
individuals at high risk of dementia. Even low-intensity activities like
stretching and balance exercises proved effective in slowing decline,
suggesting a simple and feasible path toward brain health.
Key Facts:
- Slowed Decline: Both low and moderate-high intensity exercise stabilized cognitive function over 12 months.
- Brain Volume Preservation: Participants in both exercise groups showed less brain volume loss, particularly in the prefrontal cortex.
- Community Feasibility: The trial partnered with local YMCAs, showing real-world implementation is possible.
Source: UCSD
Researchers at University
of California San Diego and Wake Forest University have found that both
low and moderate-high intensity exercise could be valuable tools in the
fight against Alzheimer’s.
The new research, published as two papers in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association,
describes the results of the EXERT study (Exercise in Adults with Mild
Memory Problems), a multi-site clinical trial of lower or moderate-high
intensity exercise in sedentary older adults with amnestic mild
cognitive impairment, a major risk factor for Alzheimer’s dementia.
The researchers also compared their results to an existing dataset of
comparable individuals who only received usual care, such as regular
check-ups with health care providers and medication management.
The researchers found:
- In
EXERT participants, cognitive function remained stable over 12 months
in both low and moderate-high intensity exercise groups. - Both
forms of exercise were associated with significantly less cognitive
decline over 12 months when compared to individuals who were not
involved in the exercise study. - Both EXERT exercise groups tended to show less brain volume loss over 12 months, including in the prefrontal cortex.
Individuals
with amnestic mild cognitive impairment, a condition characterized by
memory complaints and objective memory decline, are at high risk of
developing Alzheimer’s dementia, with approximately 16% of people with
this condition progressing to Alzheimer’s each year.
“This
is a critical time to intervene in this population, because they don’t
have dementia yet, but are at a very high risk,” said Aladdin Shadyab,
Ph.D., M.P.H., lead author of one of the new papers and associate
professor at the UC San Diego Herbert Wertheim School of Public Health
and Human Longevity Science and School of Medicine.
“Together, these findings show us that even low intensity exercise may slow cognitive decline in at-risk older adults.”
While
previous studies have suggested that exercise may be beneficial for
cognitive health, the evidence has been mixed, and large, well-designed
studies are needed to fully understand the potential benefits of
exercise for older adults with mild cognitive impairment.
The
EXERT study, coordinated by the Alzheimer’s Disease Cooperative Study
(ADCS) at UC San Diego, in partnership with Wake Forest University
School of Medicine, fills this gap.
“EXERT was one of the first
large clinical trials of exercise that partnered with the YMCA and its
trainers to bring the intervention closer to home for research
participants,” said Howard Feldman, M.D., ADCS director.
“This approach brings us one step closer to its implementation in the community.”
The
ADCS was formed in 1991 under a cooperative agreement between the
National Institute on Aging and UC San Diego and is one of the key
initiatives for Alzheimer’s research supported by the federal
government, addressing treatments for both cognitive and behavioral
symptoms of Alzheimer’s.
“There’s
an urgent need to identify effective and feasible ways to prevent and
treat Alzheimer’s dementia, and UC San Diego has been a leader in this
field for many years,” added Feldman, who is also a professor in the
Department of Neurosciences at UC San Diego School of Medicine.
EXERT included nearly 300 sedentary older adults with mild cognitive
impairment who were randomly assigned to either moderate-high intensity
aerobic training or lower-intensity stretching, balance and range of
motion activities.
Participants completed their assigned exercise
3-4 times per week for 12 months under the supervision of a YMCA
trainer, and the study also included regular assessments of cognitive
function and brain volume.
“EXERT is a landmark study because it’s
the largest rigorous trial of exercise ever conducted in adults with
mild cognitive impairment,” said Laura Baker, Ph.D., principal
investigator of the EXERT study and professor of gerontology and
geriatric medicine at Wake Forest University School of Medicine.
“Exercise
has well-documented benefits to nearly every aspect of human health,
but we’re still unlocking the full potential of exercise as medicine for
older adults with memory problems.
Though the researchers
expected to see further cognitive decline in EXERT participants, they
actually found that cognitive function remained stable for both exercise
groups over the course of the study. This suggests that both lower and
higher intensity exercise could slow cognitive decline.
Another
possible explanation for the results is that participating in research
itself, regardless of the treatment, may offer protection against
cognitive decline due to the intellectual and social stimulation
involved.
Overall, the findings of both studies taken together suggest that
exercise may be a promising, safe, and feasible strategy to promote
brain health and prevent continued cognitive decline for older adults
with mild cognitive impairment.
“While there’s still a lot to
learn, these findings show that regular intensity exercise, even at low
intensity, could go a long way toward helping older adults slow or delay
cognitive decline, and this is promising news for those who are at high
risk for dementia,” added Shadyab.
Funding: The
EXERT study was supported through the National Institutes of
Health/National Institute on Aging (U19AG010483-25 and AG058644) and by
the Brain Research Foundation (BRF ECD-2014-01).
