Physical exercise in the prevention of cognitive decline and Alzheimer’s disease

Abstract

Alzheimer’s disease (AD) is the most common type of dementia, affecting millions of people around the world. It is a devastating disease characterized by memory issues, cognitive impairment, and personality changes. It is incurable and the only available approved medications alleviate symptoms but have not been shown to substantially modify the disease. Scientists in recent years have looked to non-pharmaceutical interventions and aerobic exercise is one intervention that has come to the forefront. There is mechanistic support for aerobic exercise in human and mouse studies demonstrating that aerobic exercise can benefit brain pathology. It can improve brain glucose metabolism, lower the amount of beta amyloid, and increase brain-derived neurotrophic factor (BDNF). Therefore, an exercise intervention may have the potential to delay and prevent AD pathology and symptoms. In our study, we will attempt to demonstrate this in an expansive single-blind trial. The subjects will be 1246 adults, age 60-70 years, cognitively normal, but at a risk for AD. Participants will be randomized 1:1 to either an active control group that wears an activity smart watch and receives coaching regarding a standard stretching routine or the intervention group which has special engaging features on their smart watch and coaching to encourage individualized aerobic exercise routines. The primary outcome will be the neurological test battery composite score, demonstrating global cognitive function in these patients. We hope to clearly demonstrate that exercise interventions can be utilized to help prevent cognitive decline and delay AD.