Effect of 9 weeks continuous vs. interval aerobic training on plasma BDNF levels, aerobic fitness, cognitive capacity and quality of life among seniors with mild to moderate Alzheimer's disease: a randomized controlled trial

Lievyn Enette, Thomas Vogel, Sylvie Merle, Anna-Gaelle Valard-Guiguet, Nathalie Ozier-Lafontaine, Remi Neviere, Claudia Leuly-Joncart, Jean Luc Fanon, Pierre Olivier Lang, Lievyn Enette, Thomas Vogel, Sylvie Merle, Anna-Gaelle Valard-Guiguet, Nathalie Ozier-Lafontaine, Remi Neviere, Claudia Leuly-Joncart, Jean Luc Fanon, Pierre Olivier Lang

Abstract

Background: Evidence suggests that aerobic-type training confers physical benefits and appears to contribute positively to brain health. This study aims to compare the effect of 9-weeks continuous (CAT) to interval aerobic training (IAT) on brain derived neurotrophic factor (BDNF) plasma level, aerobic fitness, cognitive performance, and quality of life among senior with Alzheimer's disease (AD).

Methods: 52 participants were randomly allocated into three groups (CAT n = 14; IAT n = 17; and Controls n = 21). CAT and IAT consisted of 18 sessions of 30-min cycling, twice a week, over 9 weeks. During the same period, controls were engaged in interactive information sessions. Plasma BDNF level; aerobic fitness parameters (Metabolic equivalent task - METs; Maximal Tolerated Power - MTP); functional capacities (6-Minute Walk Test - 6MWT); cognitive performance (Mini Mental State Examination; Rey auditory verbal learning test; and digit span test) and quality of life (Quality Of Life of Alzheimer's Disease scale - QoL-AD) were measured in all participants at baseline and 9 weeks later. A third plasma BDNF level was quantified following a 4 weeks detraining.

Results: No significant change was measured in terms of plasma BDNF level and cognitive performance after interventions, in all groups compared to baseline. After 9 weeks, CAT and IAT significantly improved aerobic fitness parameters compared to controls (METs: + 0.6 and + 1.0 vs. + 0.4; MTP: + 16 watts and + 20 watts vs. + 10 watts; and functional capacities (6MWT: + 22 m and + 31 m vs. -40 m). Compared to controls, QoL-AD after CAT was improved (+ 2 points; p = 0.02).

Conclusions: Neither aerobic exercise modalities significantly modified plasma BDNF levels and cognitive performances. CAT and IAT enhanced aerobic fitness and functional capacities in AD patients and CAT their QoL.

Trial registration: ClinicalTrials.gov website (NCT02968875); registration date: 7 September 2016. "Retrospectively registered".

Keywords: Aerobic exercise, aerobic fitness, BDNF, Alzheimer’s disease, cognitive performance, older adults.

Conflict of interest statement

Competing interestsNone of the above listed authors has any conflicts of interests to declare for the present manuscript.

© The Author(s) 2020.

Figures

Fig. 1
Fig. 1
Consort flow diagram of inclusion, randomization and follow-up including reasons for drop-out
Fig. 2
Fig. 2
Study design and visual presentation of CAT, IAT and CG program. a = watts equivalent to 70% of HRmax or 50% of MTP. Base = watts equivalent to 60% of HRmax. Peak = watts equivalent to 80% of HRmax or MTP – 10 watts. Abbreviations: IMET, Incremental Maximal Exercise Test; BDNF, Brain Derived Neurotrophic Factor; QoL-AD, Quality of life of Alzheimer disease; 6MWT, 6 Minutes walking – test
Fig. 3
Fig. 3
Effect of 9 weeks of aerobic training and 4 weeks of detraining on BDNF plasma level
Fig. 4
Fig. 4
At the bottom, exploratory analysis of plasma BDNF level after 9 weeks of training (week-10) and after a detraining period (week-14) for continuous aerobic (CAT) and interval aerobic training (IAT) group added and control group. Data are presented as median and interquartile range. At the top BDNF plasma level during study *Significant difference between responder and non-responders at baseline (p < 0.05); **Significant difference between baseline and after 9 weeks (p < 0.05); *** Significant difference between baseline and the detraining (p < 0.05)

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