Effects of Exercise and Intensive Vascular Risk Reduction on Cognitive Function in Older Adults: A Randomized...

Area of Science:

• Gerontology
• Cardiovascular Health
• Cognitive Neuroscience

Background:

• Cardiovascular risk factors like physical inactivity, hypertension, and hyperlipidemia are linked to age-related cognitive decline and dementia.
• The potential synergistic effects of exercise and intensive risk factor reduction on cognitive function remain unclear.

Purpose of the Study:

• To evaluate the individual and combined effects of aerobic exercise and intensive cardiovascular risk factor reduction (IRVR) on cognitive function in older adults.
• To compare the benefits of exercise, IRVR, and their combination against usual care.

Main Methods:

• A 24-month, single-blind, multicenter randomized clinical trial with a 2x2 factorial design involving 513 older adults (aged 60-85) at risk for cognitive decline.
• Participants were randomized to aerobic exercise, IRVR (targeting SBP <130 mmHg and LDL-C with atorvastatin), IRVR + exercise, or usual care.
• Cognitive function was assessed using the Preclinical Alzheimer Cognitive Composite (PACC) score and the NIH Toolbox Cognition Battery (NIHTB-CB).

Main Results:

• No statistically significant interaction was found between intervention groups and time for the primary outcome.
• Both exercise and IRVR groups showed modest increases in PACC scores, but differences between groups (exercise vs. no exercise, IRVR vs. no IRVR) were not statistically significant.
• Secondary outcomes using the NIHTB-CB also showed similar non-significant differences between intervention arms.

Conclusions:

• In older adults at risk for cognitive decline, 24 months of aerobic exercise, intensive cardiovascular risk factor reduction, or a combination of both did not lead to statistically significant improvements in cognitive function compared to usual care.
• These findings suggest that while these interventions may have other health benefits, they may not be sufficient to significantly alter cognitive trajectories in this population over this timeframe.