Physical exercise for prevention of dementia (EPD) study: background, design and methods

Abstract

Background Several observational studies have shown that exercise reduces the risk of cognitive decline; however, evidences from long-term, well-conducted, randomized controlled trials are scanty. The principal aim of this study is to verify whether a long-term program of multimodal supervised exercise improves the cognitive function and/or reduces the rate of cognitive decline in older adults at different degrees of risk for dementia. Methods/design EPD is a parallel group, double-blind, randomized controlled trial. Community-dwelling volunteers aged 50 years or more are being recruited from different community centers and screened for eligibility. Enrolled subjects are being divided in 3 groups: a) without subjective or objective cognitive impairment, b) with subjective memory complaints, and c) with mild cognitive impairments. Participants in each group (at least 180) are being randomly assigned (1:1) to an experimental group, performing a supervised training including aerobic and resistance exercises of moderate/high intensity, or to a control group. Primary outcome will be 48-months changes in Mini Mental State Examinations. Secondary outcomes will be changes in several cognitive tests including a composite cognitive score. Time points will be at baseline, and at 6, 12, 24, 36 and 48 months. Statistical analysis will be done as intention to treat, complete case and mixed model analysis. Discussion EPD is the first trial to examine the effects of a long exercise program (48 months) on cognitive performances. If successful, this trial may provide evidence for using long-term and multimodal exercise interventions for dementia prevention programs in the aging population. Trial registration The study is registered at ClinicalTrials.gov with the code NCT02236416 .

Cognitive Impairment Among Older Adults With Diabetes Mellitus in Puducherry: A Community-Based Cross-Sectional Study

“…Unemployed elderly might be less physically active than their employed counterparts. Exercise has a direct effect on preserving neurogenesis and favoring neuroplasticity [23]. Studies have reported an association of physical exercise with a decreased risk of cognitive impairment.…”

Midlife physical activity is associated with lower incidence of vascular dementia but not Alzheimer’s disease

“…Among trials with physical activity as the only intervention, improved cognition was reported in patients with mild AD after 16 weeks of exercise [7], whereas no cognitive effects were seen in demented patients after 12 months [8]. An ongoing trial with a 2-year exercise intervention will provide further information if physical exercise can be beneficial in preventing dementia [9]. As summarized in reviews and meta-analyses, findings from previous prospective cohort studies differ but pooled results indicate protective effects [10–14].…”

Mecanismos Neurocognitivos de la motivación en el entrenamiento físico

“…Actualmente la evidencia científica disponible demuestra que la actividad física no solo trae consigo una gran cantidad de beneficios al estado físico general (y cardiovascular en particular), sino que también provoca beneficios en la salud mental de las personas al aliviar el estrés, mejorar el sueño, regular el estado anímico, aumentar el interés en el sexo y reducir el cansancio, aumentando el estado de alerta [48][49][50][51][52][53]. También sabemos que sirve de factor protector para algunas enfermedades neurológicas como las demencias [54][55][56][57][58] y la integración sistemática de comportamientos saludables coherentes con el envejecer generativamente [59].…”