Isometric Exercise Training for Managing Vascular Risk Factors in Mild Cognitive Impairment and Alzheimer’s Disease

Abstract

Alzheimer’s disease (AD) is the most common form of dementia diagnosed amongst the elderly. Mild cognitive impairment (MCI) is a condition often indicative of the earliest symptomatology of AD with 10%–15% of MCI patients reportedly progressing to a diagnosis of AD. Individuals with a history of vascular risk factors (VRF’s) are considered high risk candidates for developing cognitive impairment in later life. Evidence suggests that vascular injury resulting from untreated VRF’s promotes progression from MCI to AD and exacerbates the severity of dementia in AD, and neuroimaging studies have found that the neurodegenerative processes associated with AD are heavily driven by VRF’s that promote cerebral hypoperfusion. Subsequently, common links between vascular disorders such as hypertension and neurodegenerative disorders such as AD include compromised vasculature, cerebral hypoperfusion and chronic low grade inflammation (a hallmark of both hypertension and AD). Exercise has been demonstrated to be an effective intervention for blood pressure management, chronic low grade inflammation and improvements in cognition. Data from recent analyses suggests that isometric exercise training (IET) may improve vascular integrity and elicit blood pressure reductions in hypertensives greater than those seen with dynamic aerobic and resistance exercise. IET may also play an effective role in the management of VRF’s at the MCI stage of AD and may prove to be a significant strategy in the prevention, attenuation or delay of progression to AD. A plausible hypothesis is that the reactive hyperemia stimulated by IET initiates a cascade of vascular, neurotrophic and neuro-endocrine events that lead to improvements in cognitive function.

Implications of PI3K/AKT/PTEN Signaling on Superoxide Dismutases Expression and in the Pathogenesis of Alzheimer’s Disease

“…Alzheimer’s disease (AD) is the greatest form of dementia, and presently has no effective therapy to improve the symptoms [ 1 , 2 ]. The typical symbol in the diagnosis of AD has been described the increase of neurofibrillary plaques in the brain [ 3 , 4 ].…”

The impact of isometric handgrip exercise and training on health‐related factors: A review

“…Although this protocol may not increase handgrip strength (Baddeley‐White et al, 2019), there may still be important health benefits. Similar to that observed with aerobic and dynamic resistance exercise, isometric handgrip exercise has been suggested to impact some other health‐related factors including blood pressure (Millar, Paashuis, et al, 2009), pain (Naugle et al, 2012) and cognitive function (Hess & Smart, 2017). In addition, blood lipids (e.g., cholesterol and triglycerides) and lipoproteins (e.g., low‐ or high‐density lipoprotein [HDL or LDL] cholesterol) are well‐studied health‐related factors associated with cardiovascular disease risk (Ference et al, 2020; Mann et al, 2014; Wang & Xu, 2017).…”

Cellular Adaptation to Ischemia; Ischemic Conditioning to Confer Neuroprotective Benefits in Mild Cognitive Impairment and Alzheimer’s disease

“…IET can elicit blood pressure (BP) reductions greater than those achieved through aerobic exercise and equivalent to those achieved through monotherapy with beta-blocker [20]. Furthermore, there is a considerable amount of research that links hypertension to conditions of cognitive decline such MCI and AD [21].…”

“…Hypertension, a hallmark of aging, has been linked with cerebrovascular pathology, hypoperfusion [22], and cognitive decline [23]. Imaging studies have demonstrated an association between brain atrophy and untreated hypertension [24] and positive correlations have been demonstrated among SBP, diastolic blood pressure, and burden of neural AD pathology [21,25]. Hypertension is associated with structural and functional changes in cerebrovascular pathways.…”