Moderate-to-High Intensity Physical Exercise in Patients with Alzheimer’s Disease: A Randomized Controlled Trial

随机对照试验 生活质量(医疗保健) 物理疗法 医学 有氧运动 认知 置信区间 心理学 物理医学与康复 内科学 精神科 护理部
作者
Kristine Hoffmann,Nanna Aue Sobol,Kristian Steen Frederiksen,Nina Beyer,Asmus Vogel,Karsten Vestergaard,Hans Brændgaard,Hanne Gottrup,Annette Lolk,Lene Wermuth,Søren Jacobsen,Lars P. Laugesen,Robert Gergelyffy,Peter Høgh,Eva Bjerregaard,Birgitte Andersen,Volkert Siersma,Peter Johannsen,Carl W. Cotman,Gunhild Waldemar,Steen Gregers Hasselbalch
出处
期刊:Journal of Alzheimer's Disease [IOS Press]
卷期号:50 (2): 443-453 被引量:255
标识
DOI:10.3233/jad-150817
摘要

Background: Studies of physical exercise in patients with Alzheimer’s disease (AD) are few and results have been inconsistent. Objective: To assess the effects of a moderate-to-high intensity aerobic exercise program in patients with mild AD. Methods: In a randomized controlled trial, we recruited 200 patients with mild AD to a supervised exercise group (60-min sessions three times a week for 16 weeks) or to a control group. Primary outcome was changed from baseline in cognitive performance estimated by Symbol Digit Modalities Test (SDMT) in the intention-to-treat (ITT) group. Secondary outcomes included changes in quality of life, ability to perform activities of daily living, and in neuropsychiatric and depressive symptoms. Results: The ITT analysis showed no significant differences between intervention and control groups in change from baseline of SDMT, other cognitive tests, quality of life, or activities of daily living. The change from baseline in Neuropsychiatric Inventory differed significantly in favor of the intervention group (mean: –3.5, 95% confidence interval (CI) –5.8 to –1.3, p = 0.002). In subjects who adhered to the protocol, we found a significant effect on change from baseline in SDMT as compared with the control group (mean: 4.2, 95% CI 0.5 to 7.9, p = 0.028), suggesting a dose-response relationship between exercise and cognition. Conclusions: This is the first randomized controlled trial with supervised moderate-to-high intensity exercise in patients with mild AD. Exercise reduced neuropsychiatric symptoms in patients with mild AD, with possible additional benefits of preserved cognition in a subgroup of patients exercising with high attendance and intensity.
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