Invited review: "Probiotic" approaches to improving dairy production: Reassessing "magic foo-foo dust"

The gastrointestinal microbial consortium in dairy cattle is critical to determining the energetic status of the dairy cow from birth through her final lactation. The ruminant's microbial community can degrade a wide variety of feedstuffs, which can affect growth, as well as production rate and efficiency on the farm, but can also affect food safety, animal health, and environmental impacts of dairy production. Gut microbial diversity and density are powerful tools that can be harnessed to benefit both producers and consumers. The incentives in the United States to develop Alternatives to Antibiotics for use in food-animal production have been largely driven by the Veterinary Feed Directive and have led to an increased use of probiotic approaches to alter the gastrointestinal microbial community composition, resulting in improved heifer growth, milk production and efficiency, and animal health. However, the efficacy of direct-fed microbials or probiotics in dairy cattle has been highly variable due to specific microbial ecological factors within the host gut and its native microflora. Interactions (both synergistic and antagonistic) between the microbial ecosystem and the host animal physiology (including epithelial cells, immune system, hormones, enzyme activities, and epigenetics) are critical to understanding why some probiotics work but others do not. Increasing availability of next-generation sequencing approaches provides novel insights into how probiotic approaches change the microbial community composition in the gut that can potentially affect animal health (e.g., diarrhea or scours, gut integrity, foodborne pathogens), as well as animal performance (e.g., growth, reproduction, productivity) and fermentation parameters (e.g., pH, short-chain fatty acids, methane production, and microbial profiles) of cattle. However, it remains clear that all direct-fed microbials are not created equal and their efficacy remains highly variable and dependent on stage of production and farm environment. Collectively, data have demonstrated that probiotic effects are not limited to the simple mechanisms that have been traditionally hypothesized, but instead are part of a complex cascade of microbial ecological and host animal physiological effects that ultimately impact dairy production and profitability.

Effects of transportation duration on lying behavior in young surplus dairy calves

Surplus dairy calves are commonly transported long distances from dairy farms to calf-raising facilities and livestock auctions. Current calf transportation research mainly describes physiological changes resulting from transportation. However, few studies have described the effects of transportation on calf behavior. The main objective of this study was to determine the effects of different durations of transportation (6, 12, and 16 h) on lying time and bouts in surplus dairy calves. A secondary objective of this study was to investigate whether calf age affected lying behavior around transportation. Surplus dairy calves (n = 175) were transported in 7 cohorts from 5 commercial dairy farms in Ontario to a single veal facility. On the day of transportation (d 0), calves were randomly assigned to 1 of 3 treatment groups: (1) 6 h (n = 60), (2) 12 h (n = 58), or (3) 16 h (n = 57) of continuous transportation by road. Calf lying and standing behaviors were recorded using HOBO data loggers (Hobo Pendant G Acceleration Data Logger, Onset Computer Corporation). Daily lying time (h/d) and bouts (no./d) were assessed from -1 to 3 d relative to transportation. The total time spent lying during transportation was assessed as the percentage of time lying (min lying/total min on the trailer × 100) from the time each calf was loaded onto the trailer until the time each calf was unloaded at the veal facility (n = 167). On the day of transportation (d 0), calves transported for 12 and 16 h spent less time lying (6 h: 17.1 h/d; 12 h: 15.9 h/d; 16 h: 15.0 h/d) and had more lying bouts (6 h: 21.9 bouts/d; 12 h: 25.8 bouts/d; 16 h: 29.8 bouts/d) compared with those transported for 6 h. On the day after transportation (d 1), calves transported for 16 h spent more time lying down than calves transported for 6 h (19.9 h/d vs. 18.8 h/d, respectively). In addition, during transportation, calves transported for 12 h and 16 h spent 5.8% and 7.6% more time lying down, respectively, than calves transported for 6 h. On each day relative to transportation (d -1 to 3), younger calves (2 to 5 d of age) spent a greater amount of time lying down than older calves (6 to 19 d of age) and, overall, had a greater number of lying bouts. The results of this study suggest that longer durations of transportation influence the lying behavior of surplus dairy calves, resulting in more fatigue during and after the journey and, therefore, potentially have negative implications for calf welfare. Additionally, longer durations of transportation may have greater influence on younger calves than older calves.

How has the COVID-19 pandemic affected eczema self-management and help seeking? A qualitative interview study with young people and parents/carers of children with eczema

Background

Eczema can have a considerable impact on quality of life. Treatments can improve this, but management is complex. Barriers to eczema self‐management may be impacted upon by environmental context, such as the COVID‐19 pandemic.

Objectives

To explore experiences of eczema, self‐management, and accessing healthcare and advice during the COVID‐19 pandemic among young people with eczema and parents/carers of children with eczema.

Methods

Qualitative semi‐structured interviews were carried out with 36 participants recruited from general practices as part of randomised controlled trials of online eczema resources.

Results

Changes to everyday life—Periods of staying at home due to the pandemic alter the burden of eczema, with reports of an improved routine and application of topical treatments for many, but difficulties with handwashing for others. Parents/carers reported improved eczema control due to closures of educational settings. Young people reported higher stress that may have triggered eczema flare‐ups. Changes to access to advice and treatment—There was a reluctance to seek medical appointments in a non‐emergency situation. Participants reported a lack of trust in the outcome of telephone consultations because health professionals were unable to see or feel the skin. Delays or difficulties when obtaining appointments and treatments caused frustration. Access to an online eczema resource was reported to have extra value in the context of the pandemic.

Conclusion

Changes to lifestyle and access to healthcare during the pandemic have affected eczema and self‐management. Healthcare settings may want to consider providing extra reassurance around remote consultations.

Feeding colostrum or a 1:1 colostrum:whole milk mixture for 3 days after birth increases serum immunoglobulin G and apparent immunoglobulin G persistency in Holstein bulls

Conflicting reports exist on whether prolonged IgG consumption can further increase serum IgG in neonatal calves. Given that higher serum IgG in neonates has lifelong benefits, our objective was to determine whether serum IgG can be increased by providing multiple meals containing IgG to neonatal calves. Twenty-seven Holstein bulls were all fed 1 colostrum meal (7.5% body weight; 62 g of IgG/L) at 2 h after birth and randomly assigned to be fed (5% body weight) colostrum (COL; n = 9), whole milk (WM; n = 9), or a 1:1 colostrum:whole milk mixture (MX; n = 9) every 12 h from 12 to 72 h. Serum IgG was measured at 1, 2, 3, 6, 9, 11, and 12 h after birth. After the 12-h meal, IgG was determined at 0.5-h intervals until 16 h and then at 1-h intervals from 16 to 24 h. Serum IgG was then measured at 27 h, then every 6 h from 30 to 60 h. From 60 to 64 h, IgG was measured every 0.5 h, then at 65 and 66 h, and then every 2 h until 72 h. Serum IgG increased rapidly between 2 and 12 h for all calves. A treatment × time interaction occurred as serum IgG began to diverge between treatments after they were fed at 12 h; the interaction was greatest over the entire period for COL compared with both MX and WM and was greater for MX than for WM. Maximum IgG concentrations (C_max) were 30.4 ± 0.8, 27.2 ± 0.8, and 23.9 ± 0.8 g/L for COL, MX, and WM, respectively. Although MX C_max was equivalent to both COL and WM C_max, COL C_max was greater than WM C_max. Feeding COL and MX also prolonged the time to reach C_max. Respectively, these calves achieved C_max at 29.5 and 27.0 ± 3.4 h, whereas WM IgG peaked at 13.4 ± 3.4 h. No differences were observed for apparent efficiency of absorption between treatments from 0 to 12 h and 0 to 24 h. Immunoglobulin G area under the curve (AUC) was the same for COL and MX calves over the entire experimental period and from when treatments were fed. The IgG AUC for 0 to 72 h for WM calves was 27.4% lesser than that for COL calves but not different from MX calves. However, the IgG AUC for 12 to 72 h for WM calves differed relative to that for both COL (30.8% less) and MX (19.6% less) calves. Serum IgG concentrations were more persistent when COL (88.2 ± 2.4%) and MX (91.2 ± 2.4%) were fed rather than WM (75.3 ± 2.4%). Prolonged IgG consumption increased serum IgG concentrations, corresponding to the mass of IgG fed, and improved apparent IgG persistency in Holstein bulls. Neonatal calves should be fed at least 62 g of IgG at 12 h after birth to further increase serum IgG concentrations.

Age at first calving in dairy cows: which months do you aim for to maximise productivity?

PICO question In dairy cattle, which months should producers target age at first calving in order to maximise milk yield, minimize risk of non-voluntary culling and optimize fertility?   Clinical bottom line Category of research question Risk The number and type of study designs reviewed Seventeen papers were critically reviewed: 15 sets of case series, one review of case series and cohort studies and one randomised control trial, summarising over 2.4 million individual cow records Strength of evidence Strong Outcomes reported An optimum range of age at first calving (AFC) on dairy farms appears to be 22–25 months inclusive. Lower or higher than this figure can bring lower first lactation 305 day and lifetime milk yields, lower fertility and lower chances of surviving to a second lactation. Achieving an AFC of 22–25 months can bring the highest economic return to dairies Conclusion Age at first calving is a useful and key performance parameter to measure in dairy cattle. Achieving a range of 22–25 months at first calving can help to optimise both long term milk yield, fertility and longevity within the herd   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  

Feeding colostrum or a 1:1 colostrum:milk mixture for 3 days postnatal increases small intestinal development and minimally influences plasma glucagon-like peptide-2 and serum insulin-like growth factor-1 concentrations in Holstein bull calves

This study evaluated how feeding colostrum- or a colostrum-milk mixture for 3 d postnatal affects plasma glucagon-like peptide-2 (GLP-2), serum insulin-like growth factor-1 (IGF-1), and small intestinal histomorphology in calves. Holstein bulls (n = 24) were fed colostrum at 2 h postnatal and randomly assigned to receive either colostrum (COL), whole milk (WM), or a 1:1 COL:WM mixture (MIX) every 12 h from 12 to 72 h. A jugular venous catheter was placed at 1 h postnatal to sample blood frequently for the duration of the experiment. Samples were collected at 1, 2, 3, 6, 9, 11, and 12 h. Following the 12-h meal, blood was collected at half-hour intervals until 16 h and then at 1-h intervals from 16 to 24 h. A 27-h sample was taken, then blood was sampled every 6 h from 30 to 60 h. Again, blood was taken at half-intervals from 60 to 64 h, then at 65 and 66 h, following which, a 2-h sampling interval was used until 72 h. Plasma GLP-2 (all time points) and serum IGF-1 (at time points: 1, 6, 12, 18, 24, 36, 48, and 72 h) were both analyzed. Duodenal, jejunal, and ileal tissues were collected at 75 h of age to assess histomorphology and cellular proliferation. Feeding COL, rather than WM, increased plasma GLP-2 by 60% for 2 h and tended to increase GLP-2 by 49.4% for 4 h after the 60-h meal. Insulin-like growth factor-1 area under the curve (from 12 to 72 h) tended to be 27% greater for COL than WM calves but was otherwise unaffected by treatment. Ileal crypts tended to proliferate more with MIX than WM, whereas ileal crypt proliferation did not differ for COL compared with MIX or WM and was not different between treatments in the proximal jejunum. Villi height was increased 1.8 and 1.5× (COL and MIX vs. WM) in the proximal and distal jejunum, respectively, whereas MIX duodenal and ileal villi height tended to be 1.5 and 1.4× that of WM. Crypt depth did not differ in any region. Surface area of the gastrointestinal tract was reduced for WM by 60 and 58% (proximal jejunum) and 38 and 52% (ileum) relative to COL and MIX and was 54% less than MIX in the distal jejunum. Overall, extended COL feeding minimally increased plasma GLP-2 and serum IGF-1 compared with WM feeding. As COL and MIX similarly promoted small intestinal maturation, feeding calves transition milk to promote intestinal development could be a strategy for producers.

Systemic Safety of a Recombinant AAV8 Vector for Human Cocaine Hydrolase Gene Therapy: A Good Laboratory Practice Preclinical Study in Mice

Cocaine addiction continues to impose major burdens on affected individuals and broader society but is highly resistant to medical treatment or psychotherapy. This study was undertaken with the goal of Food and Drug Administration (FDA) permission for a first-in-human clinical trial of a gene therapy for treatment-seeking cocaine users to become and remain abstinent. The approach was based on intravenous administration of AAV8-hCocH, an adeno-associated viral vector encoding a modified plasma enzyme that metabolizes cocaine into harmless by-products. To assess systemic safety, we conducted "Good Laboratory Practice" (GLP) studies in cocaine-experienced and cocaine-naive mice at doses of 5E12 and 5E13 vector genomes/kg. Results showed total lack of viral vector-related adverse effects in all tests performed. Instead, mice given one injection of AAV8-hCocH and regular daily injections of cocaine had far less tissue pathology than cocaine-injected mice with no vector treatment. Biodistribution analysis showed the vector located almost exclusively in the liver. These results indicate that a liver-directed AAV8-hCocH gene transfer at reasonable dosage is safe, well tolerated, and effective. Thus, gene transfer therapy emerges as a radically new approach to treat compulsive cocaine abuse. In fact, based on these positive findings, the FDA recently accepted our latest request for investigational new drug application (IND 18579).

Short communication: Pegbovigrastim treatment in vivo does not affect granulocyte ability to migrate to endometrial cells and kill bacteria in vitro in healthy cows

In periparturient dairy cows, immune suppression, resulting in decreased neutrophil numbers and function, leads to increased susceptibility to postpartum conditions such as mastitis, retained placenta, and metritis. Administration of polyethylene glycol-conjugated bovine granulocyte colony stimulating factor (pegbovigrastim, Imrestor; Elanco Animal Health, Greenfield, IN) 7 d before and within 24 h of calving, effectively improves granulocyte production and function in vivo as well as in milk. A recently developed coculture assay was adapted for use with endometrial epithelial cells to assess the effects of pegbovigrastim application on directed granulocyte migration and bactericidal activity in vitro on a per-cell basis in endometrial cell cultures. Granulocytes from treated and untreated periparturient cows (6 and 5 per group, respectively) were evaluated for their ability to migrate to and kill bacteria after treatment, in context of the infected endometrium. We hypothesized that in addition to increasing the absolute concentration of circulating neutrophil granulocytes, pegbovigrastim treatment in vivo alters the ability of granulocytes to migrate to endometrial cells in vitro. The results clearly show a marked increase in the total concentration of granulocytes and monocytes between the 2 treatment groups as early as 2 d after the first injection, and this increased between the samples taken 2 d after calving. No migratory or killing differences were identified between granulocytes of both groups, suggesting that pegbovigrastim-induced granulocytes were as effective as non-induced cells. This may also be due to the absence of negative energy balance in the study animals and leads us to conclude that the positive effects seen in vivo are most likely based on the larger number of granulocytes present rather than a direct effect of pegbovigrastim treatment on the functionality of cells for the parameters tested in this study.

Abstract P6-12-01: Can exercise influence survival following breast cancer? Evidence from randomised, controlled trials

Background: The Exercise for Health (EfH) trials were randomized, controlled trials designed to evaluate an 8-month pragmatic, exercise intervention, commencing 6 weeks post-surgery for women with newly diagnosed breast cancer residing in urban- or rural/regional areas. Outcomes for these exploratory analyses were overall survival (OS), breast cancer-specific survival (BCS) and disease-free survival (DFS). Methods: Consenting urban-residing women (EfH 1, n=194) and rural/regional-residing women (EfH 2, n=143) were randomized to exercise or usual care. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for OS, BCS and DFS (exercise group, n=207, 65% urban women; usual care group, n=130, 46% urban women), with and without adjustment for prognostic factors including trial (urban/rural), age, body mass index, disease stage and presence of comorbidities. Further exploratory subgroup analyses were also conducted to assess whether effect on OS, BCS and DFS differed according to prognostic variables. Results: After a median follow-up of 8.3 years (IQR: 8.0-8.7 years) there were 11 (5.3%) deaths in the exercise group compared with 15 (11.5%) deaths in the usual care group (Table 1).

Table 1 Overall, breast cancer-specific and disease-free survival events by group allocation. All patientsUsual careExercise n=337n = 130n = 207 n (%)n (%)n (%)Breast cancer-related deaths20 (5.9)10 (7.7)10 (4.8)Non-breast cancer-related deaths6 (1.8)5 (3.8)1 (0.5)Overall survival events26 (7.7)15 (11.5)11 (5.3)Recurrence of breast cancer20 (5.9)8 (6.2)12 (5.8)Alive at follow-up9 (2.7)3 (2.3)6 (4.6)Deceased by follow-up11 (3.3)5 (3.1)6 (4.6)New primary breast cancer13 (3.9)5 (3.8)8 (3.9)Alive at follow-up13 (3.9)5 (3.8)8 (6.2)Deceased by follow-up0 (0.0)0 (0.0)0 (0.0)Disease-free survival events*48 (14.2)23 (17.7)25 (12.1)* Disease-free survival events include recurrence of breast cancer, new primary breast cancers, and all-cause deaths. Note that women who had recurrence and died before follow-up only count once towards disease-free survival events.

HRs for the exercise group were: OS: 0.45, 95% CI=0.20-0.96; p=0.04; BCS: 0.61, 95% CI=0.25-1.46, p=0.26; and DFS: 0.66, 95% CI=0.38-1.17; p=0.16 (adjusted analyses yielded similar results). With the exception of BCS for those with a body mass index >30, all HRs for subgroup analyses favored exercise, with effect on OS for women of younger age (<55), those with stage II+ disease, and those with 1+ comorbidity at baseline significant (p<0.05). Effect of exercise on DFS was also significant (p<0.05) for urban women. Conclusion: Findings suggest that an individually-prescribed and monitored exercise program integrated during and beyond treatment for breast cancer, and that was designed to cater for all women, irrespective of place of residence and access to health services, has clear potential to influence survival.

Citation Format: Hayes SC, Steele M, Spence R, Gordon L, Battistutta D, Bashford J, Pyke C, Saunders C, Eakin E. Can exercise influence survival following breast cancer? Evidence from randomised, controlled trials [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-12-01.

Molecular analysis and genotype-phenotype correlation of Diamond-Blackfan anemia

Diamond-Blackfan anemia (DBA) features hypoplastic anemia and congenital malformations, largely caused by mutations in various ribosomal proteins. The aim of this study was to characterize the spectrum of genetic lesions causing DBA and identify genotypes that correlate with phenotypes of clinical significance. Seventy-four patients with DBA from across Canada were included. Nucleotide-level mutations or large deletions were identified in 10 ribosomal genes in 45 cases. The RPS19 mutation group was associated with higher requirement for chronic treatment for anemia than other DBA groups. Patients with RPS19 mutations, however, were more likely to maintain long-term corticosteroid response without requirement for further chronic transfusions. Conversely, patients with RPL11 mutations were less likely to need chronic treatment. Birth defects, including cardiac, skeletal, hand, cleft lip or palate and genitourinary malformations, also varied among the various genetic groups. Patients with RPS19 mutations had the fewest number of defects, while patients with RPL5 had the greatest number of birth defects. This is the first study to show differences between DBA genetic groups with regards to treatment. Previously unreported differences in the rate and types of birth defects were also identified. These data allow better patient counseling, a more personalized monitoring plan, and may also suggest differential functions of DBA genes on ribosome and extra-ribosomal functions.

Self-compassion is associated with optimum self-care behaviour, medical outcomes and psychological well-being in a cross-sectional sample of adults with diabetes

AIM

To investigate the role of self-compassion in diabetes outcomes. Self-compassion is a construct which may be relevant to chronic conditions, given its focus on compassion toward oneself, especially in times of difficulty.

METHODS

In this cross-sectional study we collected data online from 310 adults diagnosed with diabetes. The questionnaire measured three primary outcomes: self-management behaviours; HbA_1c levels and psychological well-being. Potential predictors were also assessed, including self-compassion, locus of control, social support and demographics.

RESULTS

Multiple regression analyses showed that self-compassion had the most consistent association with better outcomes, including all forms of self-management behaviour, HbA_1c levels and psychological well-being. Self-compassion was independently associated with 55.1% of the variance in well-being. Internal locus of control was also significantly associated with better well-being and HbA_1c outcomes. Chance and external locus of control and social support were generally associated with poorer outcomes.

CONCLUSIONS

Higher levels of self-compassion are typically associated with improved self-management behaviour, medical outcomes and psychological well-being in adults with diabetes mellitus. The present findings suggest that self-compassion may be a parsimonious and suitable intervention target. Future interventions and consultations with medical professionals may benefit from fostering self-compassion in adults with diabetes mellitus.

High prevalence of multiple drug resistant staphylococci observed in macaque-populated locations in Brunei Darussalam

The spread of antibiotic resistant bacteria is a growing problem worldwide. Staphylococci bacteria is recognized as a genus of bacteria often closely related to human and animal hosts. Macaques are one type of non-human primate host that could potentially spread antibiotic resistant bacteria in an environment in close proximity to humans. Bacteria isolated from locations in Brunei Darussalam with and without the presence of long-tailed macaques revealed the existence of multiple drug resistant staphylococci bacteria with a higher prevalence observed in locations with a presence of long-tailed macaques. These findings have important zoonotic implications on infectious disease control and surveillance in public spaces frequented by macaques.

Does Heat Stress Affect Immune Function in Dairy Cows?

Clinical bottom line Heat stress appears to generally suppress innate immune function in both dry and lactating dairy cows. Immune effects that are decreased include cytokine production, proliferation of immune cells, migration of lymphocytes to the udder and cell viability. This may lead to an increase in the risk of clinical diseases such as mastitis and metritis. 

Safety studies on intravenous administration of oncolytic recombinant vesicular stomatitis virus in purpose-bred beagle dogs

VSV-IFNβ-NIS is a novel recombinant oncolytic vesicular stomatitis virus (VSV) with documented efficacy and safety in preclinical murine models of cancer. To facilitate clinical translation of this promising oncolytic therapy in patients with disseminated cancer, we are utilizing a comparative oncology approach to gather data describing the safety and efficacy of systemic VSV-IFNβ-NIS administration in dogs with naturally occurring cancer. In support of this, we executed a dose-escalation study in purpose-bred dogs to determine the maximum tolerated dose (MTD) of systemic VSV-hIFNβ-NIS, characterize the adverse event profile, and describe routes and duration of viral shedding in healthy, immune-competent dogs. The data indicate that an intravenous dose of 10(10) TCID50 is well tolerated in dogs. Expected adverse events were mild to moderate fever, self-limiting nausea and vomiting, lymphopenia, and oral mucosal lesions. Unexpected adverse events included prolongation of partial thromboplastin time, development of bacterial urinary tract infection, and scrotal dermatitis, and in one dog receiving 10(11) TCID50 (10 × the MTD), the development of severe hepatotoxicity and symptoms of shock leading to euthanasia. Viral shedding data indicate that detectable viral genome in blood diminishes rapidly with anti-VSV neutralizing antibodies detectable in blood as early as day 5 postintravenous virus administration. While low levels of viral genome copies were detectable in plasma, urine, and buccal swabs of dogs treated at the MTD, no infectious virus was detectable in plasma, urine, or buccal swabs at any of the doses tested. These studies confirm that VSV can be safely administered systemically in dogs, justifying the use of oncolytic VSV as a novel therapy for the treatment of canine cancer.

The effects of multimodal exercise on cognitive and physical functioning and brain-derived neurotrophic factor in older women: a randomised controlled trial

OBJECTIVE

to test the effect of a 16-week multimodal exercise program on neurocognitive and physical functioning and brain-derived neurotrophic factor (BDNF).

DESIGN

a single-blinded, parallel-group randomised controlled trial.

SETTINGS

university campus and community-based halls.

SUBJECTS

forty-nine women aged 65 to 75 years, with no cognitive impairment and not undertaking more than 1 h of formal exercise training per week.

METHODS

the intervention group attended a 60-min multimodal class twice each week which included cardiovascular, strength and motor fitness training. The primary outcome was neurocognitive functioning and secondary outcomes were physical functioning and plasma levels of BDNF.

RESULTS

twenty-five participants were randomised to the intervention group and 24 to the control group. One control participant withdrew before follow-up data collection. The intervention group performed significantly better than the control group at follow-up (when controlled for baseline) in the Trail Making test A and B, the California Older Adult Stroop test (Word, Interference and Total scores), Controlled Oral Word Association test and the Timed Up-and-Go test, Six-Minute Walk test, One-Legged Stance test and plasma BDNF.

CONCLUSION

this multimodal exercise program resulted in neurocognitive and physical performance improvements and increased levels of plasma BDNF, in older women, when compared with controls. This RCT provides evidence that a multimodal exercise intervention can achieve larger effect sizes than those generally resulting from single modality interventions. Increases in BDNF levels imply neurogenesis may be a component of the mechanism underpinning the cognitive improvements associated with multimodal exercise.

TRIAL REGISTRATION

Australian and New Zealand Clinical Trial Registration Number: ANZCTR12612000451808.