Effect of physical exercise and medication on enhancing cognitive function in older adults with vascular risk

Aim: To examine the association of physical exercise (PE) and medication on cognitive function in older adults with vascular risk. Methods: This was a cross-sectional study of 478 non-demented participants aged ≥60 years with vascular risk. Management strategy included PE (mind–body exercise and/or strenuous exercise), medication, PE combined with medication and no management at all. Participation of PE was determined by self-reporting exercise engagement in the past year. Cognitive preservation was defined as a global composite z-score that was equal to or above the age and educational adjusted mean of cognitively normal older adults. Binary logistic regression was carried out to examine the association between management strategy and cognitive preservation in each exercise modality adjusted by sociodemographic, physical, mental and genetic factors. Results: An association was found in preserved cognitive function for those who managed their vascular risk through PE (OR 2.5, 95% CI 1.2–5.3, P = 0.015) and in combination with medication (OR 2.1, 95% CI 1.0–4.6, P = 0.05). A similar pattern was also found in each exercise subtype. A significant short-term (OR 3.6, 95% CI 1.0–12.4, P = 0.042) to lifelong (OR 3.5, 95% CI 1.4–8.5, P = 0.006) cognitive benefit was found in MB exercise. Conclusion: Medication alone may be insufficient to preserve cognitive function in older adults with vascular risk. In our sample, medication in combined with PE is found to have significant impact on cognitive improvement. Mind–body exercise might be better than strenuous exercise, as a more sustainable cognitive effect is observed. Geriatr Gerontol Int 2020; 20: 1067–1071.