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Bonanni R, Cariati I, Cifelli P, Frank C, Annino G, Tancredi V, D'Arcangelo G. Exercise to Counteract Alzheimer's Disease: What Do Fluid Biomarkers Say? Int J Mol Sci 2024; 25:6951. [PMID: 39000060 PMCID: PMC11241657 DOI: 10.3390/ijms25136951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/14/2024] [Accepted: 06/22/2024] [Indexed: 07/16/2024] Open
Abstract
Neurodegenerative diseases (NDs) represent an unsolved problem to date with an ever-increasing population incidence. Particularly, Alzheimer's disease (AD) is the most widespread ND characterized by an accumulation of amyloid aggregates of beta-amyloid (Aβ) and Tau proteins that lead to neuronal death and subsequent cognitive decline. Although neuroimaging techniques are needed to diagnose AD, the investigation of biomarkers within body fluids could provide important information on neurodegeneration. Indeed, as there is no definitive solution for AD, the monitoring of these biomarkers is of strategic importance as they are useful for both diagnosing AD and assessing the progression of the neurodegenerative state. In this context, exercise is known to be an effective non-pharmacological management strategy for AD that can counteract cognitive decline and neurodegeneration. However, investigation of the concentration of fluid biomarkers in AD patients undergoing exercise protocols has led to unclear and often conflicting results, suggesting the need to clarify the role of exercise in modulating fluid biomarkers in AD. Therefore, this critical literature review aims to gather evidence on the main fluid biomarkers of AD and the modulatory effects of exercise to clarify the efficacy and usefulness of this non-pharmacological strategy in counteracting neurodegeneration in AD.
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Affiliation(s)
- Roberto Bonanni
- Department of Biomedicine and Prevention, "Tor Vergata" University of Rome, 00133 Rome, Italy
| | - Ida Cariati
- Department of Systems Medicine, "Tor Vergata" University of Rome, 00133 Rome, Italy
| | - Pierangelo Cifelli
- Department of Applied Clinical and Biotechnological Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Claudio Frank
- UniCamillus-Saint Camillus International University of Health Sciences, 00131 Rome, Italy
| | - Giuseppe Annino
- Department of Systems Medicine, "Tor Vergata" University of Rome, 00133 Rome, Italy
- Centre of Space Bio-Medicine, "Tor Vergata" University of Rome, 00133 Rome, Italy
- Sports Engineering Laboratory, Department of Industrial Engineering, "Tor Vergata" University of Rome, 00133 Rome, Italy
| | - Virginia Tancredi
- Department of Systems Medicine, "Tor Vergata" University of Rome, 00133 Rome, Italy
- Centre of Space Bio-Medicine, "Tor Vergata" University of Rome, 00133 Rome, Italy
| | - Giovanna D'Arcangelo
- Department of Systems Medicine, "Tor Vergata" University of Rome, 00133 Rome, Italy
- Centre of Space Bio-Medicine, "Tor Vergata" University of Rome, 00133 Rome, Italy
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Raffin J. Does Physical Exercise Modify the Pathophysiology of Alzheimer's Disease in Older Persons? JAR LIFE 2024; 13:77-81. [PMID: 38803456 PMCID: PMC11129780 DOI: 10.14283/jarlife.2024.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Abstract
Physical exercise is well known for its benefits on brain health. However, the mechanisms through which these benefits occur remain discussed, especially in the context of cognitive conditions such as Alzheimer's disease. The present short review summarizes the findings of interventional studies that examined the effects of exercise training on the specific and non-specific biomarkers of Alzheimer's disease. Controlled exercise intervention studies published in the English language were selected if they assessed the effects of a physical exercise intervention of at least 2 weeks in middle-aged or older adults on one of the following biomarkers measured either in the brain, the cerebrospinal fluid or the blood: beta-amyloid, tau, neurofilament light chain, and glial fibrillary acidic protein. Overall, there was no strong evidence of significant effects of exercise interventions on any of the selected biomarkers. However, in specific populations, such as women with obesity, pre-diabetes, or depression, favorable changes in blood beta-amyloid concentrations were reported. Further benefits on cerebrospinal fluid beta-amyloid were also demonstrated in APOE-ε4 allele carriers with Alzheimer's disease. In conclusion, the current evidence suggests that physical exercise does not modulate the pathophysiology of Alzheimer's disease in the overall population of middle-aged and older adults. Nonetheless, some specific populations, such as women with metabolic disorders and Alzheimer's disease patients with APOE-ε4 genotype, seem to be favorably affected. Further studies, including long follow-ups, large sample sizes, and concomitantly assessing the effects of other factors such as sedentary behavior and diet, are required to bring further evidence to the field.
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Affiliation(s)
- J. Raffin
- Institut Hospitalo-Universitaire (IHU) HealthAge, Toulouse, France
- Institut du Vieillissement, Gérontopôle de Toulouse, Centre Hospitalo-Universitaire de Toulouse, 37 allées Jules Guesde, 31000 Toulouse, France
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Abdullahi A, Wong TW, Ng SS. Understanding the mechanisms of disease modifying effects of aerobic exercise in people with Alzheimer's disease. Ageing Res Rev 2024; 94:102202. [PMID: 38272266 DOI: 10.1016/j.arr.2024.102202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/06/2023] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
Alzheimer's disease (AD) is a very disabling disease. Pathologically, it is characterized by the presence of amyloid plaques and neurofibrillary tangles in the brain that results in neurodegeneration. Its clinical manifestations include progressive memory impairment, language decline and difficulty in carrying out activities of daily living (ADL). The disease is managed using interventions such as pharmacological interventions and aerobic exercise. Use of aerobic exercise has shown some promises in reducing the risk of developing AD, and improving cognitive function and the ability to carry out both basic and instrumental ADL. Although, the mechanisms through which aerobic exercise improves AD are poorly understood, improvement in vascular function, brain glucose metabolism and cardiorespiratory fitness, increase in antioxidant capacity and haemoglobin level, amelioration of immune-related and inflammatory responses, modulation of concentration of circulating Neurotrophins and peptides and decrease in concentration of tau protein and cortisol level among others seem to be the possible mechanisms. Therefore, understanding these mechanisms is important to help characterize the dose and the nature of the aerobic exercise to be given. In addition, they may also help in finding ways to optimize other interventions such as the pharmacological interventions. However, more quality studies are needed to verify the mechanisms.
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Affiliation(s)
- Auwal Abdullahi
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Thomson Wl Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Shamay Sm Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
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Stojanovic M, Schindler SE, Morris JC, Head D. Effect of exercise engagement and cardiovascular risk on neuronal injury. Alzheimers Dement 2023; 19:4454-4462. [PMID: 37534906 PMCID: PMC10592382 DOI: 10.1002/alz.13400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION Neuronal health as a potential underlying mechanism of the beneficial effects of exercise has been understudied in humans. Furthermore, there has been limited consideration of potential moderators (e.g., cardiovascular health) on the effects of exercise. METHODS Clinically normal middle-aged and older adults completed a validated questionnaire about exercise engagement over a 10-year period (n = 75; age 63 ± 8 years). A composite estimate of neuronal injury was formulated that included cerebrospinal fluid-based measures of visinin-like protein-1, neurogranin, synaptosomal-associated protein 25, and neurofilament light chain. Cardiovascular risk was estimated using the Framingham Risk Score. RESULTS Cross-sectional analyses showed that greater exercise engagement was associated with less neuronal injury in the group with lower cardiovascular risk (p = 0.008), but not the group with higher cardiovascular risk (p = 0.209). DISCUSSION Cardiovascular risk is an important moderator to consider when examining the effects of exercise on cognitive and neural health, and may be relevant to personalized exercise recommendations. HIGHLIGHTS We examined the association between exercise engagement and neuronal injury. Vascular risk moderated the association between exercise and neuronal injury. Cardiovascular risk may be relevant to personalized exercise recommendations.
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Affiliation(s)
- Marta Stojanovic
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63105
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, 63110
| | - Suzanne E. Schindler
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, 63110
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University in St. Louis, St. Louis, MO, 63110
| | - John C. Morris
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, 63110
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University in St. Louis, St. Louis, MO, 63110
| | - Denise Head
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63105
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University in St. Louis, St. Louis, MO, 63110
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, 63110
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Delgado-Peraza F, Nogueras-Ortiz C, Simonsen AH, Knight DD, Yao PJ, Goetzl EJ, Jensen CS, Høgh P, Gottrup H, Vestergaard K, Hasselbalch SG, Kapogiannis D. Neuron-derived extracellular vesicles in blood reveal effects of exercise in Alzheimer's disease. Alzheimers Res Ther 2023; 15:156. [PMID: 37730689 PMCID: PMC10510190 DOI: 10.1186/s13195-023-01303-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Neuron-derived extracellular vesicles (NDEVs) in blood may be used to derive biomarkers for the effects of exercise in Alzheimer's disease (AD). For this purpose, we studied changes in neuroprotective proteins proBDNF, BDNF, and humanin in plasma NDEVs from patients with mild to moderate AD participating in the randomized controlled trial (RCT) of exercise ADEX. METHODS proBDNF, BDNF, and humanin were quantified in NDEVs immunocaptured from the plasma of 95 ADEX participants, randomized into exercise and control groups, and collected at baseline and 16 weeks. Exploratorily, we also quantified NDEV levels of putative exerkines known to respond to exercise in peripheral tissues. RESULTS NDEV levels of proBDNF, BDNF, and humanin increased in the exercise group, especially in APOE ε4 carriers, but remained unchanged in the control group. Inter-correlations between NDEV biomarkers observed at baseline were maintained after exercise. NDEV levels of putative exerkines remained unchanged. CONCLUSIONS Findings suggest that the cognitive benefits of exercise could be mediated by the upregulation of neuroprotective factors in NDEVs. Additionally, our results indicate that AD subjects carrying APOE ε4 are more responsive to the neuroprotective effects of physical activity. Unchanged NDEV levels of putative exerkines after physical activity imply that exercise engages different pathways in neurons and peripheral tissues. Future studies should aim to expand upon the effects of exercise duration, intensity, and type in NDEVs from patients with early AD and additional neurodegenerative disorders. TRIAL REGISTRATION The Effect of Physical Exercise in Alzheimer Patients (ADEX) was registered in ClinicalTrials.gov on April 30, 2012 with the identifier NCT01681602.
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Affiliation(s)
- Francheska Delgado-Peraza
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute On Aging, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Carlos Nogueras-Ortiz
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute On Aging, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Anja Hviid Simonsen
- Danish Dementia Research Centre, Copenhagen University Hospital - Rigshospitalet, 2100, Copenhagen, Denmark
| | - De'Larrian DeAnté Knight
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute On Aging, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Pamela J Yao
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute On Aging, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Edward J Goetzl
- Department of Medicine, University of California San Francisco, San Francisco, CA, 94143, USA
- Research Department, Campus for Jewish Living, San Francisco, CA, 94112, USA
| | - Camilla Steen Jensen
- Danish Dementia Research Centre, Copenhagen University Hospital - Rigshospitalet, 2100, Copenhagen, Denmark
| | - Peter Høgh
- Department of Neurology, Zealand University Hospital, 4000, Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, 1165, Copenhagen, Denmark
| | - Hanne Gottrup
- Department of Neurology, Dementia Clinic, Aarhus University Hospital, 8200, Aarhus, Denmark
| | - Karsten Vestergaard
- Department of Neurology, Dementia Clinic, Aalborg University Hospital, 9000, Aalborg, Denmark
| | - Steen Gregers Hasselbalch
- Danish Dementia Research Centre, Copenhagen University Hospital - Rigshospitalet, 2100, Copenhagen, Denmark.
| | - Dimitrios Kapogiannis
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute On Aging, National Institutes of Health, Baltimore, MD, 21224, USA.
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Yu F, Han SY, Salisbury D, Pruzin JJ, Geda Y, Caselli RJ, Li D. Feasibility and preliminary effects of exercise interventions on plasma biomarkers of Alzheimer's disease in the FIT-AD trial: a randomized pilot study in older adults with Alzheimer's dementia. Pilot Feasibility Stud 2022; 8:243. [PMID: 36461134 PMCID: PMC9716660 DOI: 10.1186/s40814-022-01200-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/03/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Alzheimer's disease (AD) biomarkers have provided a unique opportunity to understand AD pathogenesis and monitor treatment responses. However, exercise trials show mixed effects on imagining and cerebrospinal fluid biomarkers of AD. The feasibility and effects of exercise on plasma biomarkers remain unknown. The primary objective of this study was to examine the feasibility of recruitment, retention, and blood sample collection in community-dwelling older adults with mild-to-moderate AD dementia. Secondarily, it estimated the preliminary effects of 6-month aerobic and stretching exercise on plasma amyloid-β42 and Aβ40 (Aβ42/40) ratio, phosphorylated tau (p-tau) 181, and total tau (t-tau). METHODS This pilot study was implemented in year 2 of the 2-parallel group FIT-AD trial that randomized 96 participants on a 2:1 allocation ratio to moderate-intensity cycling or low-intensity stretching for 20-50 min, 3 times/week for 6 months with 6-month follow-up. Investigators (except for the statistician) and data collectors were blinded to group assignment. Fasting blood samples were collected from 26 participants at baseline and 3 and 6 months. Plasma Aβ42, Aβ40, p-tau181, and t-tau were measured using Simoa™ assays. Data were analyzed using intention-to-treat, Cohen's d, and linear mixed models. RESULTSS The sample averaged 77.6±6.99 years old and 15.4±3.00 years of education with 65% being male and 96.2% being apolipoprotein epsilon 4 gene carriers. The recruitment rate was 76.5%. The retention rate was 100% at 3 months and 96.2% at 6 months. The rate of blood collection was 88.5% at 3 months and 96.2% at 6 months. Means (standard deviation) of within-group 6-month difference in the stretching and cycling group were 0.001 (0.012) and -0.001 (0.010) for Aβ42/40 ratio, 0.609 (1.417) pg/mL and 0.101(1.579) pg/mL for p-tau181, and -0.020 (0.279) pg/mL and -0.075 (0.215) pg/mL for t-tau. Effect sizes for within-group 6-month difference were observed for p-tau181 in stretching (d=0.43 [-0.33, 1.19]) and t-tau in cycling (-0.35 [-0.87, 0.17]). CONCLUSIONS Blood collections with fasting were well received by participants and feasible with high recruitment and retention rates. Plasma biomarkers of AD may be modifiable by exercise intervention. Important design considerations are provided for future Phase III trials. TRIALS REGISTRATION ClinicalTrials.gov Identifier: NCT01954550 and posted on October 1, 2013.
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Affiliation(s)
- Fang Yu
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
| | - Seung Yong Han
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Dereck Salisbury
- Adult and Gerontological Health Cooperative, School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Jeremy J Pruzin
- Department of Neurology, Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Yonas Geda
- Department of Neurology, and Franke Barrow Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix, AZ, USA
| | | | - Danni Li
- Department of Lab Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.
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Casaletto K, Ramos-Miguel A, VandeBunte A, Memel M, Buchman A, Bennett D, Honer W. Late-life physical activity relates to brain tissue synaptic integrity markers in older adults. Alzheimers Dement 2022; 18:2023-2035. [PMID: 34994517 PMCID: PMC9259753 DOI: 10.1002/alz.12530] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/27/2021] [Accepted: 10/14/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Physical activity (PA) is widely recommended for age-related brain health, yet its neurobiology is not well understood. Animal models indicate PA is synaptogenic. We examined the relationship between PA and synaptic integrity markers in older adults. METHODS Four hundred four decedents from the Rush Memory and Aging Project completed annual actigraphy monitoring (Mean visits = 3.5±2.4) and post mortem evaluation. Brain tissue was analyzed for presynaptic proteins (synaptophysin, synaptotagmin-1, vesicle-associated membrane proteins, syntaxin, complexin-I, and complexin-II), and neuropathology. Models examined relationships between late-life PA (averaged across visits), and timing-specific PA (time to autopsy) with synaptic proteins. RESULTS Greater late-life PA associated with higher presynaptic protein levels (0.14 < β < 0.20), except complexin-II (β = 0.08). Relationships were independent of pathology but timing specific; participants who completed actigraphy within 2 years of brain tissue measurements showed largest PA-to-synaptic protein associations (0.32 < β < 0.38). Relationships between PA and presynaptic proteins were comparable across brain regions sampled. DISCUSSION PA associates with synaptic integrity in a regionally global, but time-linked nature in older adults.
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Affiliation(s)
- Kaitlin Casaletto
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Alfredo Ramos-Miguel
- Department of Pharmacology, CIBERSAM, University of the Basque Country (EHU/UPV) and Centro de Investigación Biomédica en Red de Salud Mental, Leioa, Spain
| | - Anna VandeBunte
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Molly Memel
- San Francisco VA Medical Center, San Francisco California, USA
| | - Aron Buchman
- Rush Alzheimer's Disease Center, Rush University, Chicago, Illinois, USA
| | - David Bennett
- Rush Alzheimer's Disease Center, Rush University, Chicago, Illinois, USA
| | - William Honer
- BC Mental Health and Substance Use, Services Research Institute, Vancouver, British Columbia, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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Lu WH, Giudici KV, Guyonnet S, Aggarwal G, Nguyen AD, Morley JE, Vellas B, de Souto Barreto P. Associations of plasma neurofilament light chain and progranulin with frailty in older adults. J Am Geriatr Soc 2021; 70:1236-1243. [PMID: 34908159 DOI: 10.1111/jgs.17604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/16/2021] [Accepted: 11/21/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND In previous studies, plasma neurofilament light chain (NfL) and progranulin (PGRN) levels are associated with cognitive and physical impairment in older individuals. However, evidence of their relationships with frailty is lacking. This study aims to explore the associations of plasma NfL and PGRN levels with frailty in community-dwelling older adults. METHODS We included 507 older adults (mean [standard deviation] age, 76.7 [4.5] years) with plasma NfL and PGRN measurements from the Multidomain Alzheimer Preventive Trial (MAPT). The timepoint of biomarker measurements, either 12 or 24 months after study enrollment, was defined as the baseline for each participant. Frailty phenotype (robust, pre-frail, and frail) was assessed at 12, 24, 36, 48, and 60 months by Fried's frailty criteria. The cross-sectional associations between plasma neurodegenerative biomarkers and frailty severity were examined using logistic regressions. We further used Cox proportional hazard models to evaluate the associations between plasma biomarkers and incident frailty among robust or pre-frail participants at baseline (n = 403). RESULTS At baseline, participants with high plasma NfL levels (>93.11 pg/ml [the upper quartile]) had a higher likelihood of pre-frailty or frailty compared to their normal NfL counterparts (odds ratio = 1.68; 95% confidence interval = 1.10-2.57); however, this association did not remain significant after controlling for covariates. Neither NfL nor PGRN levels showed prospective associations with incident frailty over 4 years. CONCLUSIONS This study failed to find associations of circulating NfL and PGRN levels with frailty among community-dwelling older adults in adjusted analyses. Whether plasma neurodegenerative markers serve as potential biomarkers of frailty requires further investigation.
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Affiliation(s)
- Wan-Hsuan Lu
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,Maintain Aging Research Team, CERPOP, Inserm, Université Paul Sabatier, Toulouse, France
| | - Kelly Virecoulon Giudici
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France
| | - Sophie Guyonnet
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,Maintain Aging Research Team, CERPOP, Inserm, Université Paul Sabatier, Toulouse, France
| | - Geetika Aggarwal
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA.,Henry and Amelia Nasrallah Center for Neuroscience, Saint Louis University, St. Louis, Missouri, USA
| | - Andrew D Nguyen
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA.,Henry and Amelia Nasrallah Center for Neuroscience, Saint Louis University, St. Louis, Missouri, USA
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Bruno Vellas
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,Maintain Aging Research Team, CERPOP, Inserm, Université Paul Sabatier, Toulouse, France
| | - Philipe de Souto Barreto
- Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,Maintain Aging Research Team, CERPOP, Inserm, Université Paul Sabatier, Toulouse, France
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Yu F, Mathiason MA, Han S, Gunter JL, Jones D, Botha H, Jack C. Mechanistic Effects of Aerobic Exercise in Alzheimer's Disease: Imaging Findings From the Pilot FIT-AD Trial. Front Aging Neurosci 2021; 13:703691. [PMID: 34690736 PMCID: PMC8530186 DOI: 10.3389/fnagi.2021.703691] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/19/2021] [Indexed: 12/13/2022] Open
Abstract
Despite strong evidence from animal models of Alzheimer's disease (AD) supporting aerobic exercise as a disease-modifying treatment for AD, human mechanistic studies are limited with mixed findings. The objective of this pilot randomized controlled trial was to examine the effects of 6-month aerobic exercise on hippocampal volume, temporal meta-regions of interest (ROI) cortical thickness, white matter hyperintensity (WMH) volume, and network failure quotient (NFQ), measured with MRI, in community-dwelling older adults with AD dementia. Additionally, the relationships between 6- and 12-month changes in MRI biomarkers and the AD Assessment Scale-Cognition (ADAS-Cog) were examined. Sixty participants were randomized, but one was excluded because baseline MRI failed quality control: 38 randomized to cycling and 21 to stretching. The intervention was moderate-intensity cycling for 20-50 mins, three times a week for 6 months. Control was low-intensity stretching. The study outcomes include hippocampal volume, temporal meta-ROI cortical thickness, WMH volume, and NFQ. Outcomes were measured at baseline, 6 months, and 12 months. The sample averaged 77.3 ± 6.3 years old with 15.6 ± 2.9 years of education and 53% men. Both groups experienced significant declines over 6 months in hippocampal volume (2.64% in cycling vs. 2.89% in stretching) and temporal meta-ROI cortical thickness (0.94 vs. 1.54%), and over 12 months in hippocampal volume (4.47 vs. 3.84%) and temporal meta-ROI cortical thickness (2.27 vs. 1.79%). These declines did not differ between groups. WMH volume increased significantly with the cycling group increasing less (10.9%) than stretching (24.5%) over 6 months (f = 4.47, p = 0.04) and over 12 months (12.1 vs. 27.6%, f = 5.88, p = 0.02). NFQ did not change significantly over time. Pairwise correlational analyses showed a significant negative correlation between 6-month changes in hippocampal volume and ADAS-Cog (r = -0.34, p < 0.05). To conclude, aerobic exercise may reduce the decline in hippocampal volume and temporal meta-ROI cortical thickness during the intervention period, but the effect sizes are likely to be very small and dose-dependent and reverse once the intervention stops. Aerobic exercise is effective on slowing down WMH progression but has no effect on NFQ. Hippocampal atrophy was associated with cognitive decline during the intervention period. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT01954550.
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Affiliation(s)
- Fang Yu
- Arizona State University Edson College of Nursing and Health Innovation, Phoenix, AZ, United States
- University of Minnesota School of Nursing, Minneapolis, MN, United States
| | | | - SeungYong Han
- Arizona State University Edson College of Nursing and Health Innovation, Phoenix, AZ, United States
| | | | - David Jones
- Mayo Clinic Department of Radiology, Rochester, MN, United States
| | - Hugo Botha
- Mayo Clinic Department of Radiology, Rochester, MN, United States
| | - Clifford Jack
- Mayo Clinic Department of Radiology, Rochester, MN, United States
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10
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Effect of Eight –Weeks of Resistance Training on Serum Levels of Neurofilament Light Chain and Tau Protein in Women with Multiple Sclerosis. MEDICAL LABORATORY JOURNAL 2021. [DOI: 10.52547/mlj.15.4.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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11
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Raffin J, Rolland Y, Aggarwal G, Nguyen AD, Morley JE, Li Y, Bateman RJ, Vellas B, Barreto PDS. Associations Between Physical Activity, Blood-Based Biomarkers of Neurodegeneration, and Cognition in Healthy Older Adults: The MAPT Study. J Gerontol A Biol Sci Med Sci 2021; 76:1382-1390. [PMID: 33864068 DOI: 10.1093/gerona/glab094] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Indexed: 01/12/2023] Open
Abstract
Physical activity (PA) demonstrated benefits on brain health, but its relationship with blood biomarkers of neurodegeneration remains poorly investigated. We explored the cross-sectional associations of PA with blood concentrations of neurofilament light chain (NFL) and beta amyloid (Aβ)42/40. We further examined whether the interaction between PA and these biomarkers was longitudinally related to cognition. Four-hundred and sixty-five nondemented older adults engaged in an interventional study and who had a concomitant assessment of PA levels and blood measurements of NFL (pg/mL) and Aβ 42/40 were analyzed. A composite Z-score combining 4 cognitive tests was used for cognitive assessment up to a 4-year follow-up. Multiple linear regressions demonstrated that people achieving 500-999 and 2000+ MET-min/week of PA had lower (ln)NFL concentrations than their inactive peers. Logistic regressions revealed that achieving at least 90 MET-min/week of PA was associated with a lower probability of having high NFL concentrations (ie, ≥91.961 pg/mL [third quartile]). PA was not associated with (Aβ)42/40. Mixed-model linear regressions demonstrated that the reverse relationship between PA and cognitive decline tended to be more pronounced as Aβ 42/40 increased, while it was dampened with increasing levels of (ln)NFL concentrations. This study demonstrates that PA is associated with blood NFL but not with Aβ 42/40. Furthermore, it suggests that PA may attenuate the negative association between amyloid load and cognition, while having high NFL levels mitigates the favorable relationship between PA and cognition. More investigations on non demented older adults are required for further validation of the present findings.
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Affiliation(s)
- Jérémy Raffin
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, France
| | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, France.,UMR INSERM, 1027 University of Toulouse III and Faculté de Médecine, France
| | - Geetika Aggarwal
- Division of Geriatric Medicine, Saint Louis University School of Medicine, Missouri, USA.,Henry and Amelia Nasrallah Center for Neuroscience, Saint Louis University, Missouri, USA
| | - Andrew D Nguyen
- Division of Geriatric Medicine, Saint Louis University School of Medicine, Missouri, USA.,Henry and Amelia Nasrallah Center for Neuroscience, Saint Louis University, Missouri, USA
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, Missouri, USA
| | - Yan Li
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.,Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, France.,UMR INSERM, 1027 University of Toulouse III and Faculté de Médecine, France
| | - Philipe de Souto Barreto
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, France.,UMR INSERM, 1027 University of Toulouse III and Faculté de Médecine, France
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Joisten N, Rademacher A, Warnke C, Proschinger S, Schenk A, Walzik D, Knoop A, Thevis M, Steffen F, Bittner S, Gonzenbach R, Kool J, Bloch W, Bansi J, Zimmer P. Exercise Diminishes Plasma Neurofilament Light Chain and Reroutes the Kynurenine Pathway in Multiple Sclerosis. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2021; 8:8/3/e982. [PMID: 33782190 PMCID: PMC8054957 DOI: 10.1212/nxi.0000000000000982] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/21/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To examine acute (single-bout) and training effects of high-intensity interval training (HIIT) vs standard exercise therapy (moderate continuous training [MCT]) on plasma neurofilament light chain (pNfL) and kynurenine (KYN) pathway of tryptophan degradation metabolites in persons with multiple sclerosis (pwMS). METHODS Sixty-nine pwMS (Expanded Disability Status Scale score 3.0-6.0) were randomly assigned to a HIIT or an MCT group. Changes in pNfL and KYN pathway metabolites measured in blood plasma were assessed before, after, and 3 hours after the first training session as well as after the 3-week training intervention. RESULTS Acute exercise reduced pNfL and increased the KYN pathway flux toward the neuroprotective kynurenic acid (KA). Changes in pNfL correlated positively with changes in KA and negatively with the quinolinic acid-to-KA ratio. HIIT consistently led to greater effects than MCT. Following the 3-week training intervention, the KYN pathway was activated in HIIT compared with MCT. CONCLUSION Future studies and clinical assessments of pNfL should consider acute exercise as confounding factor for measurement reliability. Moreover, exercise-induced KYN pathway rerouting might mediate neuroprotection, potentially underlying the benefits in rehabilitation for pwMS. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that acute HIIT diminishes pNfL and increases KA levels, and 3 weeks of HIIT activate the KYN pathway in pwMS. TRIAL REGISTRATION INFORMATION Clinical trial registration number: NCT03652519.
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Affiliation(s)
- Niklas Joisten
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - Annette Rademacher
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - Clemens Warnke
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - Sebastian Proschinger
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - Alexander Schenk
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - David Walzik
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - Andre Knoop
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - Mario Thevis
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - Falk Steffen
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - Stefan Bittner
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - Roman Gonzenbach
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - Jan Kool
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - Wilhelm Bloch
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - Jens Bansi
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland
| | - Philipp Zimmer
- From the Department of "Performance and Health (Sports Medicine)" (N.J., A.S., D.W., P.Z.), Institute of Sport and Sport Science, Technical University Dortmund; Department for Molecular and Cellular Sports Medicine (A.R., S.P., W.B.), Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne; Department of Neurology (C.W.), Faculty of Medicine and University Hospital Cologne, University of Cologne; Center for Preventive Doping Research/Institute of Biochemistry (A.K., M.T.), German Sport University Cologne; Department of Neurology (F.S., S.B.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University, Germany; and Department of Neurology (R.G., J.K., J.B.), Clinics of Valens, Rehabilitation Centre Valens, Switzerland.
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Moniruzzaman M, Kadota A, Akash MS, Pruitt PJ, Miura K, Albin R, Dodge HH. Effects of physical activities on dementia-related biomarkers: A systematic review of randomized controlled trials. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 6:e12109. [PMID: 33521235 PMCID: PMC7816814 DOI: 10.1002/trc2.12109] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/01/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Physical activities (PA) may lead to improved cognition in mild cognitive impairment (MCI), Alzheimer's disease (AD), and dementia. The mechanisms mediating potential PA effects are unknown. Assessment of PA effects on relevant biomarkers may provide insights into mechanisms underlying potential PA effects on cognition. METHODS We systematically reviewed randomized controlled trials (RCTs) that studied PA effects on biomarkers in MCI, AD, and dementia populations. We examined whether biological mechanisms were hypothesized to explain associations among PA, biomarkers, and cognitive functions. We used the PubMed database and searched for RCTs with PA until October 31, 2019. RESULTS Of 653 studies examining changes in biomarkers in PA trials, 18 studies met inclusion criteria for the present review. Some studies found favorable effects of PA on neurotrophic and inflammatory biomarkers. AD pathological markers were rarely investigated, with inconclusive results. Most studies were relatively small in sample size, of limited duration, and not all studies compared the changes in biomarkers between the control and experimental groups. DISCUSSION There is only limited use of potentially informative biomarkers in PA trials for MCI, AD, and dementia. Most studies did not examine the role of biomarkers to study associations between PA and cognitive functions in their analyses. Several potential biomarkers remain uninvestigated. Careful use of biomarkers may clarify mechanisms underlying PA effects on cognition. Our review serves as a useful resource for developing future PA RCTs aimed at improving cognitive functions in MCI, AD, and dementias.
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Affiliation(s)
- Mohammad Moniruzzaman
- Center for Epidemiologic Research in Asia (CERA)Shiga University of Medical ScienceOtsuJapan
- Department of Public HealthShiga University of Medical ScienceOtsuJapan
| | - Aya Kadota
- Center for Epidemiologic Research in Asia (CERA)Shiga University of Medical ScienceOtsuJapan
- Department of Public HealthShiga University of Medical ScienceOtsuJapan
| | | | - Patrick J Pruitt
- Institute of Gerontology, Wayne State UniversityDetroitMichiganUSA
- Department of NeurologyOregon Health & Science UniversityPortlandOregonUSA
| | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia (CERA)Shiga University of Medical ScienceOtsuJapan
- Department of Public HealthShiga University of Medical ScienceOtsuJapan
| | - Roger Albin
- VAAAHSNeurology Service & GRECCAnn ArborMichiganUSA
- Department of Neurology, Michigan Alzheimer's Disease CenterUniversity of MichiganAnn ArborMichiganUSA
| | - Hiroko H. Dodge
- Center for Epidemiologic Research in Asia (CERA)Shiga University of Medical ScienceOtsuJapan
- Department of NeurologyOregon Health & Science UniversityPortlandOregonUSA
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14
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Colovati MES, Novais IP, Zampol M, Mendes GD, Cernach MCS, Zanesco A. Interaction between physical exercise and APOE gene polymorphism on cognitive function in older people. ACTA ACUST UNITED AC 2020; 54:e10098. [PMID: 33331535 PMCID: PMC7727114 DOI: 10.1590/1414-431x202010098] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 09/18/2020] [Indexed: 12/27/2022]
Abstract
We aimed to present an overview of the literature regarding the interaction between physical exercise and APOE gene polymorphism on cognitive function, particularly in patients with Alzheimer's disease (AD). Firstly, this review focused on the effect of the physical exercise on cognitive function, regardless of APOE gene polymorphism. Some studies have shown that a high level of cardiorespiratory fitness is associated with less neuronal damage with an improvement in memory score tests whereas other studies failed to detect any association between physical exercise and cognitive improvement either in healthy individuals or patients with AD. Taken together, standardized protocols and more longitudinal studies are required to provide a better insight into the effects of physical exercise on cognitive function. Although there is no agreement in the literature regarding the effects of physical exercise on cognitive function, it is well established that it improves social interaction and the feeling of well-being, thereby positively contributing to the quality of life of the elderly. Regarding the influence of physical exercise on cognitive function in APOE ε4 allele carriers, the data trend shows that the carriers of allele ε4 for APOE gene were more responsive to the beneficial effects of physical exercise on cognitive function compared with non-carriers. Nevertheless, studies with larger sample sizes will provide more accuracy about this relationship.
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Affiliation(s)
- M E S Colovati
- Laboratório de Fisiopatologia do Envelhecimento, Programa de Pós-Graduação em Saúde e Meio Ambiente, Universidade Metropolitana de Santos, Santos, SP, Brasil
| | - I P Novais
- Departamento de Saúde I, Programa de Pós-Graduação em Educação Física UESB/UESC, Universidade Estadual do Sudoeste da Bahia, Jequié, BA, Brasil
| | - M Zampol
- Laboratório de Fisiopatologia do Envelhecimento, Programa de Pós-Graduação em Saúde e Meio Ambiente, Universidade Metropolitana de Santos, Santos, SP, Brasil
| | - G D Mendes
- Laboratório de Fisiopatologia do Envelhecimento, Programa de Pós-Graduação em Saúde e Meio Ambiente, Universidade Metropolitana de Santos, Santos, SP, Brasil
| | - M C S Cernach
- Laboratório de Fisiopatologia do Envelhecimento, Programa de Pós-Graduação em Saúde e Meio Ambiente, Universidade Metropolitana de Santos, Santos, SP, Brasil
| | - A Zanesco
- Laboratório de Fisiopatologia do Envelhecimento, Programa de Pós-Graduação em Saúde e Meio Ambiente, Universidade Metropolitana de Santos, Santos, SP, Brasil
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15
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Zhang L, Tang W, Chao FL, Zhou CN, Jiang L, Zhang Y, Liang X, Tang J, Qi YQ, Yang H, He Q, Zhang SS, Zhu L, Peng Y, Tang Y. Four-month treadmill exercise prevents the decline in spatial learning and memory abilities and the loss of spinophilin-immunoreactive puncta in the hippocampus of APP/PS1 transgenic mice. Neurobiol Dis 2019; 136:104723. [PMID: 31887353 DOI: 10.1016/j.nbd.2019.104723] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/20/2019] [Accepted: 12/26/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Previous studies have reported that exercise could improve the plasticity of hippocampal synapses. However, the effects of exercise on synapses in the hippocampus in Alzheimer's disease (AD) are not completely known. METHODS In this study, thirty 12-month-old male APP/PS1 double transgenic mice were randomly divided into a sedentary group (n = 15) and a running group (n = 15). Fifteen 12-month-old male wild-type littermates were assigned to the control group (n = 15). While running mice were assigned to treadmill running for four months, the control mice and sedentary mice did not run during the study period. After Morris water maze testing, five mice in each group were randomly selected for a stereological assessment of spinophilin-immunoreactive puncta in the CA1, CA2-3 and dentate gyrus (DG) of the hippocampus. RESULTS Morris water maze testing revealed that while the learning and memory abilities in sedentary APP/PS1 mice were significantly worse than those in wild-type control mice, the learning and memory abilities in running APP/PS1 mice were significantly better than those in sedentary APP/PS1 mice. The stereological results showed that the spinophilin-immunoreactive puncta numbers of the CA1, CA2-3 and DG in the hippocampus of sedentary APP/PS1 mice were significantly lower than those of wild-type control mice and that the numbers of these spines in the CA1, CA2-3 and DG in the hippocampus of running APP/PS1 mice were significantly higher than those of sedentary APP/PS1 mice. Moreover, a running-induced improvement in spatial learning and memory abilities was significantly correlated with running-induced increases in the spinophilin-immunoreactive puncta numbers in the CA1 and DG of the hippocampus. CONCLUSIONS Four-month treadmill exercise induced a significant improvement in spatial learning and memory abilities and a significant increase in the number of spinophilin-immunoreactive puncta of the CA1, CA2-3 and DG in the hippocampus of APP/PS1 mice. Running-induced improvements in spatial learning and memory abilities were significantly correlated with running-induced increases in the spinophilin-immunoreactive puncta numbers in the CA1 and DG of the hippocampus.
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Affiliation(s)
- Lei Zhang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Wei Tang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Feng-Lei Chao
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Chun-Ni Zhou
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Lin Jiang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Yi Zhang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Xin Liang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Jing Tang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Ying-Qiang Qi
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Hao Yang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Qi He
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Shan-Shan Zhang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Lin Zhu
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Yan Peng
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China
| | - Yong Tang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cell and Tissue Engineering, Chongqing Medical University, Chongqing 400016, PR China.
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Jin M, Cao L, Dai YP. Role of Neurofilament Light Chain as a Potential Biomarker for Alzheimer's Disease: A Correlative Meta-Analysis. Front Aging Neurosci 2019; 11:254. [PMID: 31572170 PMCID: PMC6753203 DOI: 10.3389/fnagi.2019.00254] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/27/2019] [Indexed: 12/31/2022] Open
Abstract
Neurofilament light (NFL) is a putative biomarker of neurodegeneration. This study evaluates the correlative association of NFL with Alzheimer's disease (AD) indices. Relevant studies were identified after a literature search in electronic databases and study selection was based on pre-determined eligibility criteria. Correlation coefficients between NFL levels and important AD indices reported by individual studies were pooled as z-scores. Meta-regression analyses were performed to evaluate the relationships between important covariates. Data from 38 studies (age 68.3 years [95% confidence interval (CI): 65.7, 70.9]; 54 % [95% CI: 50, 57] females) were used. Meta-analyses of correlation coefficients reported by the included studies showed that NFL levels in blood and cerebrospinal fluid (CSF) correlated well (r = 0.59 [95% CI: 0.45, 0.71]; p < 0.0001). NFL levels correlated with MMSE score (r = −0.345 [95% CI: −0.43, −0.25]; p = 0.0001), and age (r = 0.485 [95% CI: 0.35, 0.61]; p = 0.00001). CSF NFL levels correlated with total tau (t-tau; r = 0.39 [95% CI: 0.27, 0.50]; p = 0.0001), phosphorylated tau (p-tau; r = 0.34 [95% CI: 0.19, 0.47]; p = 0.00001), and neurogranin (r = 0.25 [95% CI: 0.12, 0.37]; p = 0.001) but not with beta amyloid (Aβ) (r = 0.00 [95%CI: −0.13, 0.12]; p = 0.937). In meta-regression, MMSE scores were associated inversely with blood NFL (metaregression coefficient (MC) −0.236 [95% CI:−0.40, −0.072; p = 0.008), and age (MC) −0.235 [−0.36, −0.11]; p = 0.001) and positively with CSF Aβ-42 (MC 0.017 [0.010, 0.023]; p = 0.00001). NFL has good correlations with t-tau, and p-tau in CSF and CSF NFL levels correlates well with blood NFL levels. These results show that NFL can be a useful biomarker for improving diagnosis and predicting prognosis in AD patients especially if age weighted.
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Affiliation(s)
- Mei Jin
- Department of Neurology, Nangang Branch, Heilongjiang Provincial Hospital, Harbin, China
| | - Li Cao
- Department of Neurology, Nangang Branch, Heilongjiang Provincial Hospital, Harbin, China
| | - Yan-Ping Dai
- Department of Neurology, Nangang Branch, Heilongjiang Provincial Hospital, Harbin, China
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Guest FL. Early Detection and Treatment of Patients with Alzheimer's Disease: Future Perspectives. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1118:295-317. [PMID: 30747429 DOI: 10.1007/978-3-030-05542-4_15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Alzheimer's disease affects approximately 6% of people over the age of 65 years. It is characterized as chronic degeneration of cortical neurons, with loss of memory, cognition and executive functions. As the disease progresses, it is accompanied by accumulation of amyloid plaques and neurofibrillary tangles in key areas of the brain, leading to a loss of neurogenesis and synaptic plasticity in the hippocampus, along with changes in the levels of essential neurotransmitters such as acetylcholine and glutamate. Individuals with concomitant diseases such as depression, diabetes and cardiovascular disorders have a higher risk of developing Alzheimer's disease, and those who have a healthier diet and partake in regular exercise and intellectual stimulation have a lower risk of developing the disorder. This chapter describes the advances made in early diagnosis of Alzheimer's disease as this could help to improve outcomes for the patients by facilitating earlier treatment.
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Affiliation(s)
- Francesca L Guest
- Taunton and Somerset NHS Trust, Musgrove Park Hospital, Taunton, Somerset, UK.
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18
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Jensen CS, Bahl JM, Østergaard LB, Høgh P, Wermuth L, Heslegrave A, Zetterberg H, Heegaard NHH, Hasselbalch SG, Simonsen AH. Exercise as a potential modulator of inflammation in patients with Alzheimer's disease measured in cerebrospinal fluid and plasma. Exp Gerontol 2019; 121:91-98. [PMID: 30980923 DOI: 10.1016/j.exger.2019.04.003] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/04/2019] [Accepted: 04/08/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Neuroinflammation is recognized as part of the pathological progression of Alzheimer's disease (AD), but the molecular mechanisms are still not entirely clear. Systemically, physical exercise has shown to have a positive modulating effect on markers of inflammation. It is not known if this general effect also takes place in the central nervous system in AD. The aim of this study was to investigate the effect of 16 weeks of moderate to high-intensity physical exercise on selected biomarkers of inflammation both systemically and in the CNS, in patients with AD. METHODS Plasma and cerebrospinal fluid (CSF) from 198 patients with Alzheimer's disease participating in the Preserving Cognition, Quality of Life, Physical Health and Functional Ability in Alzheimer's Disease: The Effect of Physical Exercise (ADEX) study were analyzed for concentrations of 8‑isoprostane, soluble trigger receptor expressed on myeloid cells 2 (sTREM2), and the MSD v-plex proinflammation panel 1 human containing interferon gamma (IFNγ), Interleukin-10 (IL10), IL12p70, IL13, IL1β, IL2, IL4, IL6, IL8, and tumor necrosis factor alpha (TNFα), before and after a 16-week intervention with physical exercise, and we studied whether changes were modulated by the patients' APOE genotype. RESULTS Most inflammatory markers remained unchanged after exercise. We found an increasing effect of 16 weeks of physical exercise on sTREM2 measured in CSF. Further, IL6 in plasma increased in the exercise group after physical exercise (mean relative change 41.03, SD 76.7), compared to controls (-0.97, SD 49.4). In a sub-analysis according to APOE genotype, we found that in ε4 carriers, exercise had a stabilizing effect on IFNγ concentration with a mean relative change of 7.84 (SD 42.6), as compared to controls (114.7 (SD 188.3), p = 0.038. CONCLUSION Our findings indicate an effect of physical exercise on markers of neuroinflammation in CSF measured by an increase in sTREM2 in patients with AD. Further, there may be a small inflammatory systemic effect related to physical exercise in patients with AD.
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Affiliation(s)
- Camilla Steen Jensen
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet University of Copenhagen, DK-2100 Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.
| | | | - Lærke Borg Østergaard
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet University of Copenhagen, DK-2100 Copenhagen, Denmark.
| | - Peter Høgh
- Department of Clinical Medicine, University of Copenhagen, Denmark; Regional Dementia Research Centre, Department of Neurology, Zealand University Hospital, DK-4000 Roskilde, Denmark.
| | - Lene Wermuth
- Dementia Clinic, Department of Neurology, Odense University Hospital, DK-5000 Odense, Denmark.
| | - Amanda Heslegrave
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, WC1N London, UK; UK Dementia Research Institute at UCL, London WC1E 6BT, UK.
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, WC1N London, UK; UK Dementia Research Institute at UCL, London WC1E 6BT, UK; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, S-431 80 Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, S-431 80 Mölndal, Sweden.
| | - Niels H H Heegaard
- Department of Clinical Biochemistry, Immunology and Genetics, Statens Serum Institut, Copenhagen, Denmark; Department of Clinical Biochemistry, University of Southern Denmark, Odense, Denmark
| | - Steen Gregers Hasselbalch
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet University of Copenhagen, DK-2100 Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.
| | - Anja Hviid Simonsen
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet University of Copenhagen, DK-2100 Copenhagen, Denmark.
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Patients with Alzheimer's disease who carry the APOE ε4 allele benefit more from physical exercise. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2019; 5:99-106. [PMID: 31011620 PMCID: PMC6461575 DOI: 10.1016/j.trci.2019.02.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Introduction Our group has completed an exercise study of 200 patients with mild Alzheimer's disease. We found improvements in cognitive, neuropsychiatric, and physical measures in the participants who adhered to the protocol. Epidemiological studies in healthy elderly suggest that exercise preserves cognitive and physical abilities to a higher extent in APOE ε4 carriers. Methods In this post hoc subgroup analysis study, we investigated whether the beneficial effect of an exercise intervention in patients with mild AD was dependent on the patients' APOE genotype. Results We found that patients who were APOE ε4 carriers benefitted more from the exercise intervention by preservation of cognitive performance and improvement in physical measures. Discussion This exploratory study establishes a possible connection between the beneficial effects of exercise in AD and the patients' APOE genotype. These findings, if validated, could greatly impact the clinical management of patients with AD and those at risk for developing AD.
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Effects of running on adiponectin, insulin and cytokines in cerebrospinal fluid in healthy young individuals. Sci Rep 2019; 9:1959. [PMID: 30760755 PMCID: PMC6374465 DOI: 10.1038/s41598-018-38201-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 12/19/2018] [Indexed: 12/17/2022] Open
Abstract
Exercise can prevent the sedentary lifestyle-related risk of metabolic and cognitive decline, but mechanisms and mediators of exercise effects on human brain are relatively unexplored. We measured acute exercise-induced changes in adiponectin, insulin and other bioactive molecules in cerebrospinal fluid (CSF) and serum from young lean individuals. Samples of serum and CSF were obtained before and 1-h after the 90-min run (75–80% HRmax; maximal heart rate), additional serum was taken at finish-line. Body composition, physical fitness, metabolic rate, cognitive functions, food preference, glucose, insulin and albumin were measured. The spectrum of 174 cytokines was assessed by protein arrays, adiponectin was also determined by ELISA and immunoblotting. CSF adiponectin decreased post-exercise by 21.3% (arrays) and 25.8% (ELISA) (p < 0.009). Immunoblotting revealed reduction in a low-molecular-weight-adiponectin (p < 0.005). CSF adiponectin positively correlated with CSF/serum albumin ratio (p < 0.022), an indicator of blood-brain-barrier permeability. CSF and serum adiponectin were positively associated with memory and running-induced changes in insulinemia and CSF insulin. Additionally, running modulated CSF levels of 16 other cytokines. Acute running reduced CSF adiponectin and modulated insulin and albumin in CSF and serum. Associations of adiponectin with memory and metabolism indicate the potential role of this bioactive molecule in mediating exercise-induced adaptive response in human brain.
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Buchman AS, Yu L, Wilson RS, Lim A, Dawe RJ, Gaiteri C, Leurgans SE, Schneider JA, Bennett DA. Physical activity, common brain pathologies, and cognition in community-dwelling older adults. Neurology 2019; 92:e811-e822. [PMID: 30651386 DOI: 10.1212/wnl.0000000000006954] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 10/16/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To examine the associations of physical activity, Alzheimer disease (AD), and other brain pathologies and cognition in older adults. METHODS We studied 454 brain autopsies from decedents in a clinical-pathologic cohort study. Nineteen cognitive tests were summarized in a global cognitive score. Total daily physical activity summarized continuous multiday recordings of activity during everyday living in the community setting. A global motor ability score summarized 10 supervised motor performance tests. A series of regression analyses were used to examine associations of physical activity, AD, and other brain pathologies with global cognition proximate to death controlling for age, sex, education, and motor abilities. RESULTS Higher levels of total daily activity (estimate 0.148, 95% confidence interval 0.053-0.244, SE 0.049, p = 0.003) and better motor abilities (estimate 0.283, 95% confidence interval, 0.175-0.390, SE 0.055, p < 0.001) were independently associated with better cognition. These independent associations remained significant when terms for AD and other pathologies were added as well as in sensitivity analyses excluding cases with poor cognition or dementia. Adding interaction terms, the associations of total daily activity and motor abilities with cognition did not vary in individuals with and without dementia. The associations of AD and other pathologies with cognition did not vary with the levels of total daily activity or motor abilities. CONCLUSIONS Physical activity in older adults may provide cognitive reserve to maintain function independent of the accumulation of diverse brain pathologies. Further studies are needed to identify the molecular mechanisms underlying this potential reserve and to ensure the causal effects of physical activity.
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Affiliation(s)
- Aron S Buchman
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada.
| | - Lei Yu
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - Robert S Wilson
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - Andrew Lim
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - Robert J Dawe
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - Chris Gaiteri
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - Sue E Leurgans
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - Julie A Schneider
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
| | - David A Bennett
- From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada
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Zucchella C, Sinforiani E, Tamburin S, Federico A, Mantovani E, Bernini S, Casale R, Bartolo M. The Multidisciplinary Approach to Alzheimer's Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment. Front Neurol 2018; 9:1058. [PMID: 30619031 PMCID: PMC6300511 DOI: 10.3389/fneur.2018.01058] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/21/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Alzheimer's disease (AD) and dementia are chronic diseases with progressive deterioration of cognition, function, and behavior leading to severe disability and death. The prevalence of AD and dementia is constantly increasing because of the progressive aging of the population. These conditions represent a considerable challenge to patients, their family and caregivers, and the health system, because of the considerable need for resources allocation. There is no disease modifying intervention for AD and dementia, and the symptomatic pharmacological treatments has limited efficacy and considerable side effects. Non-pharmacological treatment (NPT), which includes a wide range of approaches and techniques, may play a role in the treatment of AD and dementia. Aim: To review, with a narrative approach, current evidence on main NPTs for AD and dementia. Methods: PubMed and the Cochrane database of systematic reviews were searched for studies written in English and published from 2000 to 2018. The bibliography of the main articles was checked to detect other relevant papers. Results: The role of NPT has been largely explored in AD and dementia. The main NPT types, which were reviewed here, include exercise and motor rehabilitation, cognitive rehabilitation, NPT for behavioral and psychological symptoms of dementia, occupational therapy, psychological therapy, complementary and alternative medicine, and new technologies, including information and communication technologies, assistive technology and domotics, virtual reality, gaming, and telemedicine. We also summarized the role of NPT to address caregivers' burden. Conclusions: Although NPT is often applied in the multidisciplinary approach to AD and dementia, supporting evidence for their use is still preliminary. Some studies showed statistically significant effect of NPT on some outcomes, but their clinical significance is uncertain. Well-designed randomized controlled trials with innovative designs are needed to explore the efficacy of NPT in AD and dementia. Further studies are required to offer robust neurobiological grounds for the effect of NPT, and to examine its cost-efficacy profile in patients with dementia.
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Affiliation(s)
| | - Elena Sinforiani
- Alzheimer's Disease Assessment Unit, Laboratory of Neuropsychology, IRCCS Mondino Foundation, Pavia, Italy
| | - Stefano Tamburin
- Neurology Unit, University Hospital of Verona, Verona, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Angela Federico
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Elisa Mantovani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sara Bernini
- Alzheimer's Disease Assessment Unit, Laboratory of Neuropsychology, IRCCS Mondino Foundation, Pavia, Italy
| | - Roberto Casale
- Neurorehabilitation Unit, Department of Rehabilitation, HABILITA, Bergamo, Italy
| | - Michelangelo Bartolo
- Neurorehabilitation Unit, Department of Rehabilitation, HABILITA, Bergamo, Italy
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Liang JH, Xu Y, Lin L, Jia RX, Zhang HB, Hang L. Comparison of multiple interventions for older adults with Alzheimer disease or mild cognitive impairment: A PRISMA-compliant network meta-analysis. Medicine (Baltimore) 2018; 97:e10744. [PMID: 29768349 PMCID: PMC5976284 DOI: 10.1097/md.0000000000010744] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The increasing prevalence of Alzheimer disease (AD) emphasizes the need for effective treatments. Both pharmacological therapies such as nutrition therapy (NT) and nonpharmacologic therapies including traditional treatment or personalized treatment (e.g., physical exercise, music therapy, computerized cognitive training) have been approved for the treatment of AD or mild cognitive impairment (MCI) in numerous areas. METHODS The aim of this study was to compare 4 types of interventions, physical exercise (PE), music therapy (MT), computerized cognitive training (CCT), and NT, in older adults with mild to moderate AD or MCI and identify the most effective intervention for their cognitive function. We used a system of search strategies to identify relevant studies and include randomized controlled trials (RCTs), placebo-controlled trials evaluating the efficacy and safety of 4 interventions in patients with AD or MCI. We updated the relevant studies which were published before March 2017 as a full-text article. Using Bayesian network meta-analysis (NMA), we ranked cognitive ability based objectively on Mini-Mental State Examination (MMSE), and assessed neuropsychiatric symptoms based on Neuropsychiatric Inventory (NPI). Pairwise and network meta-analyses were sequentially performed for efficacy and safety of intervention compared to control group through RCTs included. RESULTS We included 17 RCTs. Fifteen trials (n = 1747) were pooled for cognition and no obvious heterogeneity was found (I = 21.7%, P = .212) in NMA, the mean difference (MD) of PE (MD = 2.1, confidence interval [CI]: 0.44-3.8) revealed that PE was significantly efficacious in the treatment group in terms of MMSE. Five trials (n = 660) assessed neuropsychiatric symptoms with an obvious heterogeneity (I = 61.6%, P = .034), the MD of CCT (MD = -7.7, CI: -14 to -2.4), revealing that CCT was significantly efficacious in NPI. CONCLUSIONS As the first NMA comparing different interventions for AD and MCI, our study suggests that PE and CCT might have a significant improvement in cognition and neuropsychiatric symptoms respectively. Moreover, nonpharmacological therapies might be better than pharmacological therapies.
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Affiliation(s)
- Jing-hong Liang
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University
| | - Yong Xu
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University
| | - Lu Lin
- School of Nursing, Medical College of Soochow University, Suzhou, PR China
| | - Rui-xia Jia
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University
| | - Hong-bo Zhang
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University
| | - Lei Hang
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University
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