Five years of exercise intervention at different intensities and development of white matter hyperintensities in community dwelling older adults, a Generation 100 sub-study

Abstract

We investigated if a five-year supervised exercise intervention with moderate-intensity continuous training (MICT) or high-intensity interval training (HIIT) versus control; physical activity according to national guidelines, attenuated the growth of white matter hyperintensities (WMH). We hypothesized that supervised exercise, in particular HIIT, reduced WMH growth. Older adults from the general population participating in the RCT Generation 100 Study were scanned at 3T MRI at baseline (age 70-77), and after 1-, 3-and 5-years. At each follow-up, cardiorespiratory fitness was measured with ergospirometry, and physical activity plus clinical data collected. Manually delineated total WMH, periventricular (PWMH), deep (DWMH), and automated total white matter hypointensity volumes were obtained. No group by time interactions were present in linear mixed model analyses with the different WMH measurements as outcomes. In the combined exercise (MICT&HIIT) group, a significant group by time interaction was uncovered for PWMH volume, with a larger increase in the MICT&HIIT group. Cardiorespiratory fitness at the follow-ups or change in cardiorespiratory fitness over time were not associated with any WMH measure. Contrary to our hypothesis, taking part in MICT or HIIT over a five-year period did not attenuate WMH growth compared to being in a control group following national physical activity guidelines.

Hippocampal neurochemicals are associated with exercise group and intensity, psychological health, and general cognition in older adults

“…Moreover, higher exercise intensity, irrespective of group, was associated with lower Cho/ Cr in the same part of the hippocampus. The MRSI results are in line with structural MRI results from the same cohort showing that the SEG group had higher rates of hippocampal atrophy [20] and white matter hyperintensity growth [105] than the CG. Additionally, our results demonstrate that sLASER allows for a detailed investigation of spatially specific metabolic profiles along the hippocampal long axis, and that the neurochemical profiles were more closely associated with functional outcome than for instance the hippocampal volume.…”

Prevention of Vascular Contributions to Cognitive Impairment and Dementia: The Role of Physical Activity and Exercise

“…15 The authors of both studies postulated that more vigorous and frequent exercise may be required for WMH volume attenuation over time. 14,15 Sex differences in AT efficacy may be another reason why these RCTs did not find intervention effects. 14,15 In a secondary analysis of the PROMoTE study (Promotion of the Mind Through Exercise)-which assessed the effect of a 6-month moderate-intensity AT walking program compared with a control group in people with CSVD and mild cognitive impairment-no significant group differences in WMH progression were observed.…”

“…15 The authors of both studies postulated that more vigorous and frequent exercise may be required for WMH volume attenuation over time. 14,15…”

“…Sex differences in AT efficacy may be another reason why these RCTs did not find intervention effects. 14,15 In a secondary analysis of the PROMoTE study (Promotion of the Mind Through Exercise)—which assessed the effect of a 6-month moderate-intensity AT walking program compared with a control group in people with CSVD and mild cognitive impairment—no significant group differences in WMH progression were observed. However, within the AT group, men exhibited reduced WMH progression compared with women.…”

Current and Future Treatments of Vascular Cognitive Impairment

“…131 The authors acknowledged that the sample size of this meta-analysis remained insufficient to detect a significant benefit of incident dementia. Small RCTs showed that exercise did not attenuate WMH progression nor improve white matter integrity in older adults, [132][133][134] while another small RCT suggested that dancing (ie, combining physical, cognitive, and social engagement) may maintain white matter integrity. 135 Meta-analysis including both observational studies and RCTs showed that intentional weight loss among obese/overweight people was associated with improvement in cognitive functions.…”