TY - JOUR
T1 - Aerobic exercise in older people with subclinical sporadic cerebral small vessel disease
T2 - A randomized clinical trial
AU - Wong, Adrian
AU - Lam, Bonnie Yin Ka
AU - Mak, Margaret Kit Yi
AU - Lam, Linda Chiu Wa
AU - Au, Lisa Wing Chi
AU - Yiu, Brian Ka Fung
AU - Wong, Chun
AU - Tong, Hor Yee
AU - Yeung, Sin Ki
AU - Chu, Winnie Chiu Wing
AU - Shi, Lin
AU - Leung, Thomas Wai Hong
AU - Soo, Yannie Oi Yan
AU - Lau, Alexander Yuk Lun
AU - Ip, Bonaventure Yiu Ming
AU - Kwok, Timothy Chi Yui
AU - Ko, Ho
AU - Mok, Vincent Chung Tong
N1 - Funding Information:
The authors thank Ms. Winnie Wong (physiotherapist) for conducting the aerobic dance and stretching exercise training. We thank Rachel Chau, Anthea Ng, Stanley Yiu, Eugene Lo, Alison Ma, Pauline Kwan, and Vincent Hui for their contributions to this study. The authors are also indebted to all the participants of the study. This study is funded by the Health and Medical Research Fund of the Food and Health Bureau of the Government of Hong Kong SAR (Reference number 03140936).
Funding Information:
In the past 36 months, Adrian Wong reports payment from Hong Kong Court (payment made to him). Margaret Kit Yi Mak reports conference attendance support from The Hong Kong Polytechnic University to attend the XXVI World Congress on Parkinson's Disease and Related Disorders May 1–4, 2021. Linda Chiu Wa Lam reports consulting fees from the second expert Colloquium on Early Alzheimer's Disease organized by Eisai Pharmaceutical (zoom meeting in 2020); and giving a lecture and preparing a newsletter article on mental disorders for dentists for the Hong Kong Dental Association (2020); and she is a member of the Advisory Committee on Mental Health at the Food and Health Bureau of the HKSAR government. Sin Ki Yeung reports the provision of reading materials by the professor for the submitted work. Lin Shi reports grants from Hong Kong General Research Fund and Innovation and Technology Fund. Thomas Wai Hong Leung is the president of Hong Kong Neurological Society (unpaid). Yannie Oi Yan Soo reports grants from Hong Kong Health and Medical Research Fund (payment made to CUHK) and Emerging Markets Thrombosis Investigator‐Initiated Research Program from Pfizer (payment made to CUHK); and honorarium for being a speaker from Amgen (payment made to her), honorarium for being a speaker from Daiichi and Boehringer Ingelheim (Hong Kong) Ltd (payment made to CUHK); and support for conference attendance by Hong Kong Neurological and Hong Kong Stroke Societies (no direct payment involved). Timothy Chi Yui Kwok is the director of Jockey Club Centre for positive ageing, Hong Kong; reports honorarium for attending a hearing for guardianship board, Hong Kong; and payment from Hong Kong government for expert report for coroner office; and donation for research (donation made to CUHK). Ho Ko reports grants from Croucher Innovation Award, Collaborative Research Fund of the Research Grants Council, Hong Kong and Area of Excellence Scheme of the Research Grants Council, Hong Kong (payments made to CUHK); and consulting fees from Videns Incorporation Limited. He has patents on the identifications of new potential disease‐modifying therapeutics for Niemann‐Pick disease type C, a method for slowing down brain aging, and new methods for achieving rapid and deep immunostaining. All other authors declare no financial disclosures or conflicts of interest.
Publisher Copyright:
© 2021 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association
PY - 2021/12/31
Y1 - 2021/12/31
N2 - Introduction: The benefit and risk of aerobic exercise among older people harboring advanced cerebral small vessel disease (CSVD) upon cognition, mood, and motor functions are unknown. Methods: This rater-blind randomized trial examined effects of a 24-week aerobic exercise training (60 min/session, twice/week) upon clinical (cognition, mood, motor functions) and hemodynamic (pulse pressure [PP], blood pressure [BP], pulsatility index) measures in older people harboring moderate to severe CSVD, as evidenced by confluent white matter hyperintensity and/or ≥2 lacunes on magnetic resonance imaging. We further investigated interactions between treatment conditions and hemodynamics measures. Results: Fifty-three and 54 subjects were randomized into the active and control group, respectively. There was no between-group difference in any of the clinical outcomes. The active group had a greater between-group reduction in systolic BP and PP than the control group. Within-group comparison showed that global cognition of the active group remained similar at end of the study compared to baseline, whereas it declined significantly in the control group. We observed “diverging” interaction effects in that greater reduction in systolic BP/PP was associated with greater improvement in memory functions and global cognition but worsening in processing speed in the active group. Side effects were comparable between the two groups. Discussion: Future study should investigate the mechanisms of the diverging impacts of aerobic exercise upon different cognitive domains so that the benefit–risk ratio of aerobic exercise in older people harboring more advanced CSVD can be better defined.
AB - Introduction: The benefit and risk of aerobic exercise among older people harboring advanced cerebral small vessel disease (CSVD) upon cognition, mood, and motor functions are unknown. Methods: This rater-blind randomized trial examined effects of a 24-week aerobic exercise training (60 min/session, twice/week) upon clinical (cognition, mood, motor functions) and hemodynamic (pulse pressure [PP], blood pressure [BP], pulsatility index) measures in older people harboring moderate to severe CSVD, as evidenced by confluent white matter hyperintensity and/or ≥2 lacunes on magnetic resonance imaging. We further investigated interactions between treatment conditions and hemodynamics measures. Results: Fifty-three and 54 subjects were randomized into the active and control group, respectively. There was no between-group difference in any of the clinical outcomes. The active group had a greater between-group reduction in systolic BP and PP than the control group. Within-group comparison showed that global cognition of the active group remained similar at end of the study compared to baseline, whereas it declined significantly in the control group. We observed “diverging” interaction effects in that greater reduction in systolic BP/PP was associated with greater improvement in memory functions and global cognition but worsening in processing speed in the active group. Side effects were comparable between the two groups. Discussion: Future study should investigate the mechanisms of the diverging impacts of aerobic exercise upon different cognitive domains so that the benefit–risk ratio of aerobic exercise in older people harboring more advanced CSVD can be better defined.
KW - aerobic exercise
KW - cerebral small vessel disease
KW - cognitive impairment
KW - randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=85124388013&partnerID=8YFLogxK
U2 - 10.1002/trc2.12224
DO - 10.1002/trc2.12224
M3 - Journal article
AN - SCOPUS:85124388013
SN - 2352-8737
VL - 7
JO - Alzheimer's and Dementia: Translational Research and Clinical Interventions
JF - Alzheimer's and Dementia: Translational Research and Clinical Interventions
IS - 1
M1 - e12224
ER -
