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Effect of Physical Activity on Cognitive Function in Older Adults at Risk for Alzheimer Disease: A Randomized Trial
Abstract
CONTEXT: Many observational studies have shown that physical activity reduces the risk of cognitive decline; however, evidence from randomized trials is lacking. OBJECTIVE: To determine whether physical activity reduces the rate of cognitive decline among older adults at risk. DESIGN AND SETTING: Randomized controlled trial of a 24-week physical activity intervention conducted between 2004 and 2007 in metropolitan Perth, Western Australia. Assessors of cognitive function were blinded to group membership. PARTICIPANTS: We recruited volunteers who reported memory problems but did not meet criteria for dementia. Three hundred eleven individuals aged 50 years or older were screened for eligibility, 89 were not eligible, and 52 refused to participate. A total of 170 participants were randomized and 138 participants completed the 18-month assessment. INTERVENTION: Participants were randomly allocated to an education and usual care group or to a 24-week home-based program of physical activity. MAIN OUTCOME MEASURE: Change in Alzheimer Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) scores (possible range, 0-70) over 18 months. RESULTS: In an intent-to-treat analysis, participants in the intervention group improved 0.26 points (95% confidence interval, -0.89 to 0.54) and those in the usual care group deteriorated 1.04 points (95% confidence interval, 0.32 to 1.82) on the ADAS-Cog at the end of the intervention. The absolute difference of the outcome measure between the intervention and control groups was -1.3 points (95% confidence interval,-2.38 to -0.22) at the end of the intervention. At 18 months, participants in the intervention group improved 0.73 points (95% confidence interval, -1.27 to 0.03) on the ADAS-Cog, and those in the usual care group improved 0.04 points (95% confidence interval, -0.46 to 0.88). Word list delayed recall and Clinical Dementia Rating sum of boxes improved modestly as well, whereas word list total immediate recall, digit symbol coding, verbal fluency, Beck depression score, and Medical Outcomes 36-Item Short-Form physical and mental component summaries did not change significantly. CONCLUSIONS: In this study of adults with subjective memory impairment, a 6-month program of physical activity provided a modest improvement in cognition over an 18-month follow-up period. TRIAL REGISTRATION: anzctr.org.au Identifier: ACTRN12605000136606.
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“Exercise has also been shown to be neuroprotective, to delay the onset and progression, and reduce the risk for many neurodegenerative diseases, including Alzheimer’s disease (AD) and Parkinson’s disease (PD) [17, 39, 58, 89, 108, 163, 193, 199].”
From The neuropathology of sport (2014) · cites this paper as [108]
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Metadata
- Authors
- Lautenschlager, N. T., Cox, K. L., Flicker, L., Foster, J. K., van Bockxmeer, F. M., Xiao, J., Greenop, K. R., & Almeida, O. P.
- Affiliations
- The University of Western Australia (AU)
- The University of Melbourne (AU)
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2008-09-03
- Volume
- 300
- Issue
- 9
- Pages
- 1027
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W1980542913
- Semantic Scholar
- 57ce275d16532a4a1df832553cdc80e8945150a7
- Cited by
- 1,637
- References
- 54
- Citations by year
- 2026: 38 · 2025: 68 · 2024: 58 · 2023: 59 · 2022: 74 · 2021: 89 · 2020: 91 · 2019: 101 · 2018: 108 · 2017: 105 · 2016: 84 · 2015: 115 · 2014: 112 · 2013: 116 · 2012: 117
- FWCI
- 68.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Australasian Journal of Paramedicine (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- Funders
- Medical Research Council
- National Health and Medical Research Council (303172)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- physical activity, cognitive decline, Alzheimer's disease risk, older adults, subjective memory impairment, home exercise program, ADAS-Cog, memory retrieval, dementia prevention, depression, physical fitness, Western Australia, Perth
- MeSH terms
- Affect, Aged, Alzheimer Disease, Apolipoproteins E, Cognition, Depression, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Patient Education as Topic, Quality of Life, Risk Factors, Exercise
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