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      Aerobic exercise and vascular cognitive impairment : A randomized controlled trial

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          Abstract

          Objective:

          To assess the efficacy of a progressive aerobic exercise training program on cognitive and everyday function among adults with mild subcortical ischemic vascular cognitive impairment (SIVCI).

          Methods:

          This was a proof-of-concept single-blind randomized controlled trial comparing a 6-month, thrice-weekly, progressive aerobic exercise training program (AT) with usual care plus education on cognitive and everyday function with a follow-up assessment 6 months after the formal cessation of aerobic exercise training. Primary outcomes assessed were general cognitive function (Alzheimer's Disease Assessment Scale–Cognitive subscale [ADAS-Cog]), executive functions (Executive Interview [EXIT-25]), and activities of daily living (Alzheimer's Disease Cooperative Study–Activities of Daily Living [ADCS-ADL]).

          Results:

          Seventy adults randomized to aerobic exercise training or usual care were included in intention-to-treat analyses (mean age 74 years, 51% female, n = 35 per group). At the end of the intervention, the aerobic exercise training group had significantly improved ADAS-Cog performance compared with the usual care plus education group (−1.71 point difference, 95% confidence interval [CI] −3.15 to −0.26, p = 0.02); however, this difference was not significant at the 6-month follow-up (−0.63 point difference, 95% CI −2.34 to 1.07, p = 0.46). There were no significant between-group differences at intervention completion and at the 6-month follow-up in EXIT-25 or ADCS-ADL performance. Examination of secondary measures showed between-group differences at intervention completion favoring the AT group in 6-minute walk distance (30.35 meter difference, 95% CI 5.82 to 54.86, p = 0.02) and in diastolic blood pressure (−6.89 mm Hg difference, 95% CI −12.52 to −1.26, p = 0.02).

          Conclusions:

          This study provides preliminary evidence for the efficacy of 6 months of thrice-weekly progressive aerobic training in community-dwelling adults with mild SIVCI, relative to usual care plus education.

          ClinicalTrials.gov identifier:

          NCT01027858.

          Classification of evidence:

          This study provides Class II evidence that for adults with mild SIVCI, an aerobic exercise program for 6 months results in a small, significant improvement in ADAS-Cog performance.

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          Author and article information

          Contributors
          Journal
          Neurology
          Neurology
          neurology
          neur
          neurology
          NEUROLOGY
          Neurology
          Lippincott Williams & Wilkins (Hagerstown, MD )
          0028-3878
          1526-632X
          15 November 2016
          15 November 2017
          : 87
          : 20
          : 2082-2090
          Affiliations
          Author affiliations are provided at the end of the article.
          Author notes
          Correspondence to Dr. Liu-Ambrose: teresa.ambrose@ 123456ubc.ca

          An abstract of preliminary analyses was presented at the Alzheimer's Association International Conference, Washington, DC, July 23, 2015.

          Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

          Article
          PMC5109938 PMC5109938 5109938 NEUROLOGY2016723718
          10.1212/WNL.0000000000003332
          5109938
          27760869
          4bf0a02e-54fc-448a-9597-461dcc1d8a63
          © 2016 American Academy of Neurology
          History
          : 09 February 2016
          : 05 July 2016
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