Aerobic Exercise Found to Improve Cognition in Mild Vascular Cognitive Impairment

Investigators reported that, in a randomized controlled trial, patients with vascular cognitive impairment showed improvement on cognitive tests after participating in a six-month exercise program. Independent experts said the findings were promising, but preliminary.

Progressive aerobic-exercise training for six months appeared to improve cognition in adults with mild subcortical ischemic vascular cognitive impairment, defined by the presence of white matter lesions and lacunar infarcts, according to a Canadian study reported in the October 19 online edition of Neurology.

Despite its small sample size, this proof-of-concept study — one of the only randomized controlled trials to investigate the association — provides class 2 evidence of exercise’s positive impact on cognition, the study authors said.

Previous research had been based mainly on observational studies evaluating aerobic exercise as a means to boost cognitive function in individuals with mild subcortical ischemic vascular cognitive impairment, the most common form of vascular cognitive impairment.

The benefits of physical activity may include a decreased risk of cardiovascular disease as well as other more complex mechanisms, such as a surge in brain neurotrophins or an effect on neurogenesis, the authors of an editorial accompanying the study wrote.]

But the editorial cast the positive effects in a much more modest light, and questioned whether the findings should be consider class 2 evidence. “The clinical meaningfulness of this study is relatively small,” Alexandra Foubert-Samier, MD, PhD, the editorial’s co-author and a researcher at Bordeaux University Hospital’s Institut des Maladies Neurodégénératives-Clinique in Bordeaux, France, told Neurology Today. “To have an impact on cognition, the difference would need to be at least four points.”

A positive result on only one of three outcome measures does not offer adequate justification for this study to be considered as class 2 evidence, she and her colleagues wrote in the editorial. They also found it surprising that the aerobic exercise program did not improve executive functions, which would have been expected following several observational studies.

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