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May 26, 2020; 94 (21) Article

Aerobic exercise improves cognition and cerebrovascular regulation in older adults

View ORCID ProfileVeronica Guadagni, Lauren L. Drogos, Amanda V. Tyndall, Margie H. Davenport, Todd J. Anderson, Gail A. Eskes, R. Stewart Longman, View ORCID ProfileMichael D. Hill, David B. Hogan, Marc J. Poulin
First published May 13, 2020, DOI: https://doi.org/10.1212/WNL.0000000000009478
Veronica Guadagni
From the Department of Physiology and Pharmacology (V.G., L.L.D., A.V.T., G.A.E., M.J.P.), Hotchkiss Brain Institute (V.G., L.L.D., A.V.T., R.S.L., M.D.H., D.B.H., M.J.P.), Division of Geriatric Medicine (D.B.H.), Department of Medicine, Department of Clinical Neurosciences (V.G., L.L.D., A.V.T., M.D.H., D.B.H., M.J.P.), Libin Cardiovascular Institute of Alberta (T.J.A., M.J.P.), O'Brien Institute for Public Health (V.G., D.B.H., M.J.P.), Department of Cardiac Sciences (T.J.A.), Libin Cardiovascular Institute of Alberta, and Department of Community Health Sciences (M.D.H.), Cumming School of Medicine, Faculty of Kinesiology (M.J.P.), and Department of Psychology (R.S.L.), University of Calgary; Psychology Service (R.S.L.), Alberta Health Service, Foothills Medical Centre, Calgary; Department of Psychiatry (G.A.E.), Faculty of Medicine, and Department of Psychology and Neuroscience (G.A.E.), Faculty of Science, Dalhousie University, Halifax, Nova Scotia; and Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory (M.H.D.), Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Canada.
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Lauren L. Drogos
From the Department of Physiology and Pharmacology (V.G., L.L.D., A.V.T., G.A.E., M.J.P.), Hotchkiss Brain Institute (V.G., L.L.D., A.V.T., R.S.L., M.D.H., D.B.H., M.J.P.), Division of Geriatric Medicine (D.B.H.), Department of Medicine, Department of Clinical Neurosciences (V.G., L.L.D., A.V.T., M.D.H., D.B.H., M.J.P.), Libin Cardiovascular Institute of Alberta (T.J.A., M.J.P.), O'Brien Institute for Public Health (V.G., D.B.H., M.J.P.), Department of Cardiac Sciences (T.J.A.), Libin Cardiovascular Institute of Alberta, and Department of Community Health Sciences (M.D.H.), Cumming School of Medicine, Faculty of Kinesiology (M.J.P.), and Department of Psychology (R.S.L.), University of Calgary; Psychology Service (R.S.L.), Alberta Health Service, Foothills Medical Centre, Calgary; Department of Psychiatry (G.A.E.), Faculty of Medicine, and Department of Psychology and Neuroscience (G.A.E.), Faculty of Science, Dalhousie University, Halifax, Nova Scotia; and Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory (M.H.D.), Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Canada.
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Amanda V. Tyndall
From the Department of Physiology and Pharmacology (V.G., L.L.D., A.V.T., G.A.E., M.J.P.), Hotchkiss Brain Institute (V.G., L.L.D., A.V.T., R.S.L., M.D.H., D.B.H., M.J.P.), Division of Geriatric Medicine (D.B.H.), Department of Medicine, Department of Clinical Neurosciences (V.G., L.L.D., A.V.T., M.D.H., D.B.H., M.J.P.), Libin Cardiovascular Institute of Alberta (T.J.A., M.J.P.), O'Brien Institute for Public Health (V.G., D.B.H., M.J.P.), Department of Cardiac Sciences (T.J.A.), Libin Cardiovascular Institute of Alberta, and Department of Community Health Sciences (M.D.H.), Cumming School of Medicine, Faculty of Kinesiology (M.J.P.), and Department of Psychology (R.S.L.), University of Calgary; Psychology Service (R.S.L.), Alberta Health Service, Foothills Medical Centre, Calgary; Department of Psychiatry (G.A.E.), Faculty of Medicine, and Department of Psychology and Neuroscience (G.A.E.), Faculty of Science, Dalhousie University, Halifax, Nova Scotia; and Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory (M.H.D.), Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Canada.
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Margie H. Davenport
From the Department of Physiology and Pharmacology (V.G., L.L.D., A.V.T., G.A.E., M.J.P.), Hotchkiss Brain Institute (V.G., L.L.D., A.V.T., R.S.L., M.D.H., D.B.H., M.J.P.), Division of Geriatric Medicine (D.B.H.), Department of Medicine, Department of Clinical Neurosciences (V.G., L.L.D., A.V.T., M.D.H., D.B.H., M.J.P.), Libin Cardiovascular Institute of Alberta (T.J.A., M.J.P.), O'Brien Institute for Public Health (V.G., D.B.H., M.J.P.), Department of Cardiac Sciences (T.J.A.), Libin Cardiovascular Institute of Alberta, and Department of Community Health Sciences (M.D.H.), Cumming School of Medicine, Faculty of Kinesiology (M.J.P.), and Department of Psychology (R.S.L.), University of Calgary; Psychology Service (R.S.L.), Alberta Health Service, Foothills Medical Centre, Calgary; Department of Psychiatry (G.A.E.), Faculty of Medicine, and Department of Psychology and Neuroscience (G.A.E.), Faculty of Science, Dalhousie University, Halifax, Nova Scotia; and Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory (M.H.D.), Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Canada.
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Todd J. Anderson
From the Department of Physiology and Pharmacology (V.G., L.L.D., A.V.T., G.A.E., M.J.P.), Hotchkiss Brain Institute (V.G., L.L.D., A.V.T., R.S.L., M.D.H., D.B.H., M.J.P.), Division of Geriatric Medicine (D.B.H.), Department of Medicine, Department of Clinical Neurosciences (V.G., L.L.D., A.V.T., M.D.H., D.B.H., M.J.P.), Libin Cardiovascular Institute of Alberta (T.J.A., M.J.P.), O'Brien Institute for Public Health (V.G., D.B.H., M.J.P.), Department of Cardiac Sciences (T.J.A.), Libin Cardiovascular Institute of Alberta, and Department of Community Health Sciences (M.D.H.), Cumming School of Medicine, Faculty of Kinesiology (M.J.P.), and Department of Psychology (R.S.L.), University of Calgary; Psychology Service (R.S.L.), Alberta Health Service, Foothills Medical Centre, Calgary; Department of Psychiatry (G.A.E.), Faculty of Medicine, and Department of Psychology and Neuroscience (G.A.E.), Faculty of Science, Dalhousie University, Halifax, Nova Scotia; and Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory (M.H.D.), Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Canada.
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Gail A. Eskes
From the Department of Physiology and Pharmacology (V.G., L.L.D., A.V.T., G.A.E., M.J.P.), Hotchkiss Brain Institute (V.G., L.L.D., A.V.T., R.S.L., M.D.H., D.B.H., M.J.P.), Division of Geriatric Medicine (D.B.H.), Department of Medicine, Department of Clinical Neurosciences (V.G., L.L.D., A.V.T., M.D.H., D.B.H., M.J.P.), Libin Cardiovascular Institute of Alberta (T.J.A., M.J.P.), O'Brien Institute for Public Health (V.G., D.B.H., M.J.P.), Department of Cardiac Sciences (T.J.A.), Libin Cardiovascular Institute of Alberta, and Department of Community Health Sciences (M.D.H.), Cumming School of Medicine, Faculty of Kinesiology (M.J.P.), and Department of Psychology (R.S.L.), University of Calgary; Psychology Service (R.S.L.), Alberta Health Service, Foothills Medical Centre, Calgary; Department of Psychiatry (G.A.E.), Faculty of Medicine, and Department of Psychology and Neuroscience (G.A.E.), Faculty of Science, Dalhousie University, Halifax, Nova Scotia; and Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory (M.H.D.), Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Canada.
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R. Stewart Longman
From the Department of Physiology and Pharmacology (V.G., L.L.D., A.V.T., G.A.E., M.J.P.), Hotchkiss Brain Institute (V.G., L.L.D., A.V.T., R.S.L., M.D.H., D.B.H., M.J.P.), Division of Geriatric Medicine (D.B.H.), Department of Medicine, Department of Clinical Neurosciences (V.G., L.L.D., A.V.T., M.D.H., D.B.H., M.J.P.), Libin Cardiovascular Institute of Alberta (T.J.A., M.J.P.), O'Brien Institute for Public Health (V.G., D.B.H., M.J.P.), Department of Cardiac Sciences (T.J.A.), Libin Cardiovascular Institute of Alberta, and Department of Community Health Sciences (M.D.H.), Cumming School of Medicine, Faculty of Kinesiology (M.J.P.), and Department of Psychology (R.S.L.), University of Calgary; Psychology Service (R.S.L.), Alberta Health Service, Foothills Medical Centre, Calgary; Department of Psychiatry (G.A.E.), Faculty of Medicine, and Department of Psychology and Neuroscience (G.A.E.), Faculty of Science, Dalhousie University, Halifax, Nova Scotia; and Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory (M.H.D.), Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Canada.
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Michael D. Hill
From the Department of Physiology and Pharmacology (V.G., L.L.D., A.V.T., G.A.E., M.J.P.), Hotchkiss Brain Institute (V.G., L.L.D., A.V.T., R.S.L., M.D.H., D.B.H., M.J.P.), Division of Geriatric Medicine (D.B.H.), Department of Medicine, Department of Clinical Neurosciences (V.G., L.L.D., A.V.T., M.D.H., D.B.H., M.J.P.), Libin Cardiovascular Institute of Alberta (T.J.A., M.J.P.), O'Brien Institute for Public Health (V.G., D.B.H., M.J.P.), Department of Cardiac Sciences (T.J.A.), Libin Cardiovascular Institute of Alberta, and Department of Community Health Sciences (M.D.H.), Cumming School of Medicine, Faculty of Kinesiology (M.J.P.), and Department of Psychology (R.S.L.), University of Calgary; Psychology Service (R.S.L.), Alberta Health Service, Foothills Medical Centre, Calgary; Department of Psychiatry (G.A.E.), Faculty of Medicine, and Department of Psychology and Neuroscience (G.A.E.), Faculty of Science, Dalhousie University, Halifax, Nova Scotia; and Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory (M.H.D.), Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Canada.
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David B. Hogan
From the Department of Physiology and Pharmacology (V.G., L.L.D., A.V.T., G.A.E., M.J.P.), Hotchkiss Brain Institute (V.G., L.L.D., A.V.T., R.S.L., M.D.H., D.B.H., M.J.P.), Division of Geriatric Medicine (D.B.H.), Department of Medicine, Department of Clinical Neurosciences (V.G., L.L.D., A.V.T., M.D.H., D.B.H., M.J.P.), Libin Cardiovascular Institute of Alberta (T.J.A., M.J.P.), O'Brien Institute for Public Health (V.G., D.B.H., M.J.P.), Department of Cardiac Sciences (T.J.A.), Libin Cardiovascular Institute of Alberta, and Department of Community Health Sciences (M.D.H.), Cumming School of Medicine, Faculty of Kinesiology (M.J.P.), and Department of Psychology (R.S.L.), University of Calgary; Psychology Service (R.S.L.), Alberta Health Service, Foothills Medical Centre, Calgary; Department of Psychiatry (G.A.E.), Faculty of Medicine, and Department of Psychology and Neuroscience (G.A.E.), Faculty of Science, Dalhousie University, Halifax, Nova Scotia; and Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory (M.H.D.), Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Canada.
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Marc J. Poulin
From the Department of Physiology and Pharmacology (V.G., L.L.D., A.V.T., G.A.E., M.J.P.), Hotchkiss Brain Institute (V.G., L.L.D., A.V.T., R.S.L., M.D.H., D.B.H., M.J.P.), Division of Geriatric Medicine (D.B.H.), Department of Medicine, Department of Clinical Neurosciences (V.G., L.L.D., A.V.T., M.D.H., D.B.H., M.J.P.), Libin Cardiovascular Institute of Alberta (T.J.A., M.J.P.), O'Brien Institute for Public Health (V.G., D.B.H., M.J.P.), Department of Cardiac Sciences (T.J.A.), Libin Cardiovascular Institute of Alberta, and Department of Community Health Sciences (M.D.H.), Cumming School of Medicine, Faculty of Kinesiology (M.J.P.), and Department of Psychology (R.S.L.), University of Calgary; Psychology Service (R.S.L.), Alberta Health Service, Foothills Medical Centre, Calgary; Department of Psychiatry (G.A.E.), Faculty of Medicine, and Department of Psychology and Neuroscience (G.A.E.), Faculty of Science, Dalhousie University, Halifax, Nova Scotia; and Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory (M.H.D.), Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Canada.
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Aerobic exercise improves cognition and cerebrovascular regulation in older adults
Veronica Guadagni, Lauren L. Drogos, Amanda V. Tyndall, Margie H. Davenport, Todd J. Anderson, Gail A. Eskes, R. Stewart Longman, Michael D. Hill, David B. Hogan, Marc J. Poulin
Neurology May 2020, 94 (21) e2245-e2257; DOI: 10.1212/WNL.0000000000009478

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This article has a correction. Please see:

  • Aerobic exercise improves cognition and cerebrovascular regulation in older adults - November 10, 2020
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Abstract

Objective To test the hypothesis that aerobic exercise is associated with improvements in cognition and cerebrovascular regulation, we enrolled 206 healthy low-active middle-aged and older adults (mean ± SD age 65.9 ± 6.4 years) in a supervised 6-month aerobic exercise intervention and assessed them before and after the intervention.

Methods The study is a quasi-experimental single group pre/postintervention study. Neuropsychological tests were used to assess cognition before and after the intervention. Transcranial Doppler ultrasound was used to measure cerebral blood flow velocity. Cerebrovascular regulation was assessed at rest, during euoxic hypercapnia, and in response to submaximal exercise. Multiple linear regression was used to examine the association between changes in cognition and changes in cerebrovascular function.

Results The intervention was associated with improvements in some cognitive domains, cardiorespiratory fitness, and cerebrovascular regulation. Changes in executive functions were negatively associated with changes in cerebrovascular resistance index (CVRi) during submaximal exercise (β = −0.205, p = 0.013), while fluency improvements were positively associated with changes in CVRi during hypercapnia (β = 0.106, p = 0.03).

Conclusion The 6-month aerobic exercise intervention was associated with improvements in some cognitive domains and cerebrovascular regulation. Secondary analyses showed a novel association between changes in cognition and changes in cerebrovascular regulation during euoxic hypercapnia and in response to submaximal exercise.

Glossary

BIM=
Brain in Motion;
CBF=
cerebral blood flow;
CVCi=
cerebrovascular conductance index;
CVRi=
cerebrovascular resistance index;
MCA=
middle cerebral artery;
MAP=
mean arterial pressure;
MoCA=
Montreal Cognitive Assessment;
PCA=
principal component analysis;
TCD=
transcranial Doppler

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • CME Course: NPub.org/cmelist

  • Received July 9, 2019.
  • Accepted in final form November 22, 2019.
  • © 2020 American Academy of Neurology
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