The effects of an extensive exercise programme on the progression of Mild Cognitive Impairment (MCI): study protocol for a randomised controlled trial

Abstract

BackgroundExercise interventions to prevent dementia and delay cognitive decline have gained considerable attention in recent years. Human and animal studies have demonstrated that regular physical activity targets brain function by increasing cognitive reserve. There is also evidence of structural changes caused by exercise in preventing or delaying the genesis of neurodegeneration. Although initial studies indicate enhanced cognitive performance in patients with mild cognitive impairment (MCI) following an exercise intervention, little is known about the effect of an extensive, controlled and regular exercise regimen on the neuropathology of patients with MCI. This study aims to determine the effects of an extensive exercise programme on the progression of MCI.Methods/designThis randomised controlled clinical intervention study will take place across three European sites. Seventy-five previously sedentary patients with a clinical diagnosis of MCI will be recruited at each site. Participants will be randomised to one of three groups. One group will receive a standardised 1-year extensive aerobic exercise intervention (3 units of 45 min/week). The second group will complete stretching and toning (non-aerobic) exercise (3 units of 45 min/week) and the third group will act as the control group. Change in all outcomes will be measured at baseline (T0), after six months (T1) and after 12 months (T2). The primary outcome, cognitive performance, will be determined by a neuropsychological test battery (CogState battery, Trail Making Test and Verbal fluency). Secondary outcomes include Montreal Cognitive Assessment (MoCA), cardiovascular fitness, physical activity, structural changes of the brain, quality of life measures and measures of frailty. Furthermore, outcome variables will be related to genetic variations on genes related to neurogenesis and epigenetic changes in these genes caused by the exercise intervention programme.DiscussionThe results will add new insights into the prevailing notion that exercise may slow the rate of cognitive decline in MCI.Trial registrationClinicalTrials.gov NCT02913053

Patients Who Attend Alone at a First Memory Consultation: Are They a Specific Population,or Is It an Instance of Confounding Bias?

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Acute high-intensity aerobic exercise affects brain-derived neurotrophic factor in mild cognitive impairment: a randomised controlled study

“…Participants were screened and recruited from a network of memory clinics (n=38) and through community recruitment (n=26) 15 16. Details of the study inclusion and exclusion criteria have been published in the NeuroExercise study protocol 16.…”

“…Participants were screened and recruited from a network of memory clinics (n=38) and through community recruitment (n=26) 15 16. Details of the study inclusion and exclusion criteria have been published in the NeuroExercise study protocol 16. To summarise, participants had a diagnosis of amnestic MCI due to AD according to the National Institute on Aging and Alzheimer’s Association criteria,17 scored 18–26 on the Montreal Cognitive Assessment (MoCA)18 and were classified as having memory decline but not dementia (Clinical Dementia Rating global score=0.5).…”

Cognitive Impairment Is Reflected by an Increased Difference between Real and Imagined Timed Up and Go Test Performance

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