By 2050, over 150 million people could be living with dementia [1], a statistic that underscores the urgent need for effective prevention strategies.
Amidst this growing concern, a recent study, the EXERT trial, reveals how regular aerobic and balance-related exercises could play a pivotal role in not just slowing but potentially preventing the cognitive decline associated with Alzheimer’s disease.
EXERT trial findings
The EXERT trial, a rigorous Phase 3 study, explored the impacts of structured exercise regimens on individuals diagnosed with mild cognitive impairment (MCI), often a precursor to Alzheimer’s.
Conducted across multiple centers and led by researchers from institutions like Wake Forest University and the University of California, the trial enrolled 296 participants who were then divided into two groups: one undertook moderate intensity aerobic training (AX), while the other engaged in stretching, balance, and range of motion exercises (SBR).
Over the course of 18 months, these participants, previously sedentary older adults, showed no significant cognitive decline, a stark contrast to a matched group from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) who experienced expected deteriorations in cognitive functions.
“Neither the AX group nor the SBR group showed declines on the ADAS-Cog-Exec and CDR-SB, which measure global cognitive function and dementia severity, respectively,” reported Laura Baker, PhD, from Wake Forest University School of Medicine [2].
Exercise and cognitive health
The implications of these findings are significant, as Maria Carrillo, PhD, Alzheimer’s Association’s chief science officer, notes, “These topline results are remarkable and encouraging. They suggest that regular physical activity, even modest or low exertion activity such as stretching, may protect brain cells against damage” [3]
Experts in the field agree that the mechanisms behind exercise’s protective effects may include enhanced blood flow to the brain, reduced inflammation markers, and increased brain volume, particularly in regions like the hippocampus and anterior cingulate cortex, which are crucial for cognitive processing and memory [4].
Challenges and considerations
While the results are promising, the researchers are cautious about overgeneralization. “What’s critical is that regular exercise must be supported and often supervised for people with MCI,” Dr. Baker added, emphasizing the importance of a structured and socially engaging exercise regimen [3].
This element of socialization, provided weekly through the program, could also contribute significantly to the cognitive benefits observed.
Furthermore, while the exercise regimens were associated with maintaining cognitive function, the lack of significant differences in treatment outcomes between the aerobic and stretching groups suggests that the intensity of the exercise might be less important than previously thought.
Instead, the regularity and volume of exercise and social interactions seem to play a more crucial role in stalling cognitive decline.
With Alzheimer’s treatment costs soaring and the effectiveness of pharmacological interventions still under scrutiny, the potential for exercise to offer a low-cost, accessible, and widely beneficial intervention is more critical than ever.
The study’s findings offer hope for those with MCI but also call for public health strategies focusing on the broader adoption of physical activity as a preventive measure against cognitive decline.
[1] Alzheimer’s Research UK. Worldwide dementia cases to triple by 2050 to over 150 million people
[2] Alzheimer’s and Dementia. Topline Results of EXERT: Can Exercise Slow Cognitive Decline in MCI?
[3] MedPage Today. Regular Exercise Program May Stall Cognitive Decline
[4] Big Think. Aerobic exercise is surprisingly good at slowing, preventing Alzheimer’s
