Background Vascular cognitive impairment (VCI) results from cerebrovascular disease, and worldwide, it is the second most common type of cognitive dysfunction. While targeted aerobic training is a promising approach to delay the progression of VCI by reducing cardiometabolic risk factors, few randomised controlled trials to date have specifically assessed the efficacy of aerobic training on cognitive and brain outcomes in this group at risk for functional decline.
Aim To examine the effect of moderate-intensity aerobic training on executive functions and functional neural activity among older adults with mild subcortical ischaemic VCI (SIVCI).
Methods Older adults with mild SIVCI were randomly assigned to: (1) 6-month, 3×/week aerobic training (n=10) or (2) usual care (control; n=11). Participants completed functional MRI (fMRI) at baseline and trial completion. During the fMRI sessions, behavioural performance on the Eriksen flanker task and task-evoked neural activity were assessed.
Results At trial completion, after adjusting for baseline general cognition, total white matter lesion volume and flanker performance, compared with the control group, the aerobic training group significantly improved flanker task reaction time. Moreover, compared with the controls, the aerobic training group demonstrated reduced activation in the left lateral occipital cortex and right superior temporal gyrus. Reduced activity in these brain regions was significantly associated with improved (ie, faster) flanker task performance at trial completion.
Summary Aerobic training among older adults with mild SIVCI can improve executive functions and neural efficiency of associated brain areas. Future studies with greater sample size should be completed to replicate and extend these findings.
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Contributors TLA, JJE, LAB and GYRH were involved in the study concept, design, acquisition of data, preparation and critical review of the manuscript. CLH, TLA, JCD and JRB were involved in writing of the manuscript. CLH and JRB were involved in statistical analyses. CLH, TLA, JRB and LSN were involved in interpretation of data. CLH, SW and LSN were involved in functional MRI data analyses. JJE, LAB, JCD, MWV and LSN were involved in critical review of the manuscript. We thank Dr. Philip Lee for screening potential participants.
Funding CLH is an Alzheimer Society Research Program Doctoral trainee. JRB is a Canadian Institutes of Health Research and Michael Smith Foundation of Health Research Post-Doctoral Fellow. TLA is a Canada Research Chair (Tier II) in Physical Activity, Mobility, and Cognitive Neuroscience. JJE is a Canada Research Chair (Tier 1) in Neurological Rehabilitation. This work was supported by Canadian Stroke Network and the Heart and Stroke Foundation of Canada to TLA and the Jack Brown and Family Alzheimer Research Foundation Society to TLA.
Competing interests None declared.
Ethics approval Ethical approval was provided by the University of British Columbia’s Clinical Research Ethics Board (H07-01160).
Provenance and peer review Not commissioned; externally peer reviewed.