RT Journal Article
SR Electronic
T1 Lifestyle and neurocognition in older adults with cognitive impairments
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP e212
OP e223
DO 10.1212/WNL.0000000000006784
VO 92
IS 3
A1 James A. Blumenthal
A1 Patrick J. Smith
A1 Stephanie Mabe
A1 Alan Hinderliter
A1 Pao-Hwa Lin
A1 Lawrence Liao
A1 Kathleen A. Welsh-Bohmer
A1 Jeffrey N. Browndyke
A1 William E. Kraus
A1 P. Murali Doraiswamy
A1 James R. Burke
A1 Andrew Sherwood
YR 2019
UL http://n.neurology.org/content/92/3/e212.abstract
AB Objective To determine the independent and additive effects of aerobic exercise (AE) and the Dietary Approaches to Stop Hypertension (DASH) diet on executive functioning in adults with cognitive impairments with no dementia (CIND) and risk factors for cardiovascular disease (CVD).Methods A 2-by-2 factorial (exercise/no exercise and DASH diet/no DASH diet) randomized clinical trial was conducted in 160 sedentary men and women (age >55 years) with CIND and CVD risk factors. Participants were randomly assigned to 6 months of AE, DASH diet nutritional counseling, a combination of both AE and DASH, or health education (HE). The primary endpoint was a prespecified composite measure of executive function; secondary outcomes included measures of language/verbal fluency, memory, and ratings on the modified Clinical Dementia Rating Scale.Results Participants who engaged in AE (d = 0.32, p = 0.046) but not those who consumed the DASH diet (d = 0.30, p = 0.059) demonstrated significant improvements in the executive function domain. The largest improvements were observed for participants randomized to the combined AE and DASH diet group (d = 0.40, p = 0.012) compared to those receiving HE. Greater aerobic fitness (b = 2.3, p = 0.049), reduced CVD risk (b = 2.6, p = 0.042), and reduced sodium intake (b = 0.18, p = 0.024) were associated with improvements in executive function. There were no significant improvements in the memory or language/verbal fluency domains.Conclusions These preliminary findings show that AE promotes improved executive functioning in adults at risk for cognitive decline.ClinicalTrials.gov identifier NCT01573546.Classification of evidence This study provides Class I evidence that for adults with CIND, AE but not the DASH diet significantly improves executive functioning.AE=aerobic exercise; CDR=Clinical Dementia Rating; CIND=cognitive impairment without dementia; COWA=Controlled Oral Word Association Test; CVD=cardiovascular disease; DASH=Dietary Approaches to Stop Hypertension; DDD=daily defined dose; ENLIGHTEN=Exercise and Nutritional Interventions for Neurocognitive Health Enhancement; FINGER=Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability; FSRP=Framingham Stroke Risk Profile; MoCA=Montreal Cognitive Assessment; TMT=Trail Making Test