The Effects of a Moderate Physical Activity Intervention on Physical Fitness and Cognition in Healthy Elderly with Low Levels of Physical Activity: a Randomized Controlled Trial

Overview

Journal Alzheimers Res Ther

Date 2023 Jan 11

PMID 36631905

Authors

Sara A Galle

Jan Berend Deijen

Maarten V Milders

Mathieu H G de Greef

Erik J A Scherder

Cornelia M Van Duijn

Madeleine L Drent

Affiliations

Soon will be listed here.

Abstract

Background: Increasing physical activity is one of the most promising and challenging interventions to delay or prevent cognitive decline and dementia.

Methods: We conducted a randomized controlled trial to assess the effects of a physical activity intervention, aimed at increasing step count, in elderly with low levels of physical activity on measures of strength, balance, aerobic capacity, and cognition. Participants were assigned to 9 months of exercise counseling or active control.

Results: The intention-to-treat analyses show that the intervention, compared to control, increases the level of physical activity, but has no significant effect on physical fitness and cognition. Those who increased their physical activity with 35% or more show significant improvements in aerobic capacity, gait speed, verbal memory, executive functioning, and global cognition, compared to those who did not achieve a 35% increase.

Limitations: The number of participants that achieved the intended improvement was lower than expected.

Conclusion: Responder analyses suggest an improvement of physical fitness and cognition in those who achieved an increase in physical activity of at least 35%.

Trial Registration: The trial protocol is registered at the Dutch Trial Register NL5675, August 1, 2016.

Citing Articles

The effect of the APOE4 genotype on physiological and cognitive health in randomised controlled trials with an exercise intervention: a systematic review and meta-analysis.

Spencer F, Elsworthy R, Breen L, Bishop J, Dunleavy C, Aldred S Trials. 2025; 26(1):20.

PMID: 39828710 PMC: 11744846. DOI: 10.1186/s13063-024-08696-4.

Joint association of physical activity and the geriatric nutritional risk index with survival outcomes among cancer survivors in the United States: a population-based cohort study.

Wei J, Zeng Q, Liu M Front Nutr. 2025; 11():1483507.

PMID: 39807216 PMC: 11725468. DOI: 10.3389/fnut.2024.1483507.

Regular physical activity and high educational attainment positively affect cognitive function among older adults.

Kang S J Exerc Rehabil. 2025; 20(6):235-239.

PMID: 39781506 PMC: 11704709. DOI: 10.12965/jer.2448644.322.

The bidirectional association between self-perceptions of aging and frailty: the mediating role of subjective cognitive decline.

Fang X, Deng M, Zhang W, Wang L, Wang H, Xu P BMC Geriatr. 2024; 24(1):985.

PMID: 39623338 PMC: 11610300. DOI: 10.1186/s12877-024-05577-y.

Elucidation of the inhibitory effects of Jiedu Yizhi formula on neuronal apoptosis in the treatment of Alzheimer's disease based on network pharmacology and in vivo experiments.

Cui T, Yu P, Feng X, Song Q, Yang D, Li M Metab Brain Dis. 2024; 40(1):38.

PMID: 39576427 DOI: 10.1007/s11011-024-01444-2.

References

Beason-Held L, Moghekar A, Zonderman A, Kraut M, Resnick S . Longitudinal changes in cerebral blood flow in the older hypertensive brain. Stroke. 2007; 38(6):1766-73. DOI: 10.1161/STROKEAHA.106.477109. View

Rubak S, Sandbaek A, Lauritzen T, Christensen B . Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract. 2005; 55(513):305-12. PMC: 1463134. View

Cornelissen V, Fagard R . Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors. Hypertension. 2005; 46(4):667-75. DOI: 10.1161/01.HYP.0000184225.05629.51. View

Reuben D, Judd-Hamilton L, Harris T, Seeman T . The associations between physical activity and inflammatory markers in high-functioning older persons: MacArthur Studies of Successful Aging. J Am Geriatr Soc. 2003; 51(8):1125-30. DOI: 10.1046/j.1532-5415.2003.51380.x. View

Podewils L, Guallar E, Kuller L, Fried L, Lopez O, Carlson M . Physical activity, APOE genotype, and dementia risk: findings from the Cardiovascular Health Cognition Study. Am J Epidemiol. 2005; 161(7):639-51. DOI: 10.1093/aje/kwi092. View

Tudor-Locke C, Craig C, Aoyagi Y, Bell R, Croteau K, De Bourdeaudhuij I . How many steps/day are enough? For older adults and special populations. Int J Behav Nutr Phys Act. 2011; 8:80. PMC: 3169444. DOI: 10.1186/1479-5868-8-80. View

Kivipelto M, Rovio S, Ngandu T, Kareholt I, Eskelinen M, Winblad B . Apolipoprotein E epsilon4 magnifies lifestyle risks for dementia: a population-based study. J Cell Mol Med. 2008; 12(6B):2762-71. PMC: 3828889. DOI: 10.1111/j.1582-4934.2008.00296.x. View

Rovio S, Kareholt I, Helkala E, Viitanen M, Winblad B, Tuomilehto J . Leisure-time physical activity at midlife and the risk of dementia and Alzheimer's disease. Lancet Neurol. 2005; 4(11):705-11. DOI: 10.1016/S1474-4422(05)70198-8. View

Etnier J, Caselli R, Reiman E, Alexander G, Sibley B, Tessier D . Cognitive performance in older women relative to ApoE-epsilon4 genotype and aerobic fitness. Med Sci Sports Exerc. 2007; 39(1):199-207. DOI: 10.1249/01.mss.0000239399.85955.5e. View

10.

Harris T, Owen C, Victor C, Adams R, Ekelund U, Cook D . A comparison of questionnaire, accelerometer, and pedometer: measures in older people. Med Sci Sports Exerc. 2009; 41(7):1392-402. DOI: 10.1249/MSS.0b013e31819b3533. View

11.

Altenburg W, Ten Hacken N, Bossenbroek L, Kerstjens H, de Greef M, Wempe J . Short- and long-term effects of a physical activity counselling programme in COPD: a randomized controlled trial. Respir Med. 2014; 109(1):112-21. DOI: 10.1016/j.rmed.2014.10.020. View

12.

Ainsworth B, Haskell W, Herrmann S, Meckes N, Bassett Jr D, Tudor-Locke C . 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011; 43(8):1575-81. DOI: 10.1249/MSS.0b013e31821ece12. View

13.

Blaauwbroek R, Bouma M, Tuinier W, Groenier K, de Greef M, Meyboom-de Jong B . The effect of exercise counselling with feedback from a pedometer on fatigue in adult survivors of childhood cancer: a pilot study. Support Care Cancer. 2008; 17(8):1041-8. PMC: 2707951. DOI: 10.1007/s00520-008-0533-y. View

14.

Tudor-Locke C, Myers A, Bell R, Harris S, Rodger N . Preliminary outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type 2 diabetes. Patient Educ Couns. 2002; 47(1):23-8. DOI: 10.1016/s0738-3991(01)00169-0. View

15.

Twisk J, de Boer M, de Vente W, Heymans M . Multiple imputation of missing values was not necessary before performing a longitudinal mixed-model analysis. J Clin Epidemiol. 2013; 66(9):1022-8. DOI: 10.1016/j.jclinepi.2013.03.017. View

16.

Folstein M, Folstein S, McHugh P . "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-98. DOI: 10.1016/0022-3956(75)90026-6. View

17.

Huisingh-Scheetz M, Wroblewski K, Kocherginsky M, Huang E, Dale W, Waite L . The Relationship Between Physical Activity and Frailty Among U.S. Older Adults Based on Hourly Accelerometry Data. J Gerontol A Biol Sci Med Sci. 2017; 73(5):622-629. PMC: 5905616. DOI: 10.1093/gerona/glx208. View

18.

Shih I, Paul K, Haan M, Yu Y, Ritz B . Physical activity modifies the influence of apolipoprotein E ε4 allele and type 2 diabetes on dementia and cognitive impairment among older Mexican Americans. Alzheimers Dement. 2017; 14(1):1-9. PMC: 5750101. DOI: 10.1016/j.jalz.2017.05.005. View

19.

Helmrich S, Ragland D, Leung R, Paffenbarger Jr R . Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med. 1991; 325(3):147-52. DOI: 10.1056/NEJM199107183250302. View

20.

Snowden M, Steinman L, Mochan K, Grodstein F, Prohaska T, Thurman D . Effect of exercise on cognitive performance in community-dwelling older adults: review of intervention trials and recommendations for public health practice and research. J Am Geriatr Soc. 2011; 59(4):704-16. DOI: 10.1111/j.1532-5415.2011.03323.x. View