Investigating fitness and physical activity increase as secondary prevention of Alzheimer's disease in a sports interventional approach

RWTH Publications (RWTH Aachen)

Abstract

Ageing society and rising life expectancy are associated with increased prevalence of chronic diseases like dementia, representing a major public health challenge. Aside from pharmacological therapies, preventive approaches offering easily accessible treatment options are major targets in current research. Beneficial disease-modulating effects have been described for physical activity and exercise increasing cardiorespiratory fitness. Yet previous studies are often heterogenous regarding the intervention design, the clinical characterization of the participants, and ignoring the mutual relation of these two parameters resulting in inconsistent findings and remaining optimization options for such interventions in the elderly and cognitively impaired generation. The study Dementia-MOVE is a six-month randomized controlled trial including 46 people (mean age 70 ± 7 years, 18 women) with early-stage Alzheimer’s disease. The participants were randomized to either a multicomponent sports intervention group or a control group attending a psychoeducational program. The modulating effect of fitness and physical activity on changes in Alzheimer’s disease outcome parameters such as neuropsychiatric symptoms, cognition, and cerebral brain structure captured via 3T MRI scans were examined using group and multiple linear regression analyses. As an additional aspect, three methods for assessing physical activity - a wearable fitness tracker, a written diary, and a physical activity questionnaire (PAQ-50) - were compared in terms of acceptance, reliability and applicability within the described cohort over the course of the intervention. An increase in fitness, assessed by the change in maximal oxygen uptake (ΔVO2max), was associated with assignment to the intervention group, lower baseline fitness levels, and a higher rate of physical activity. Only in the intervention group, ΔVO2max had a beneficial modulating effect on the MoCA score, the executive functions score and regional brain volumes of the temporal lobe. High daily step count was associated with preserved executive functions and caregivers’ quality of life in the overall sample. The comparison of the activity monitoring methods revealed a high acceptance and compliance of all three methods. Especially data from fitness trackers and diaries showed high overlap and were unaffected by disease-dependent influence factors. In conclusion, our intervention design was effective in increasing cardiorespiratory fitness, which was associated with advantageous developments in cognitive performance and preservation of brain structure in Alzheimer’s disease. Affected individuals should therefore be encouraged to engage in physical activity. Furthermore, activity monitoring via fitness trackers or written diaries is reliable for use in people with early-stage Alzheimer’s disease.

Authors 1

1. Shari David corresponding Aachen

   RWTH Aachen University

   Affiliation as printed

   RWTH Aachen