Establishing Reference Cardiorespiratory Fitness Parameters in Alzheimer's Disease

Dereck Salisbury, Fang Yu, Dereck Salisbury, Fang Yu

Abstract

Evidence is growing for aerobic exercise training as a viable means to attenuate cognitive losses associated with Alzheimer's disease. The mechanism of action for aerobic exercise's cognitive benefits is likely enhanced cardiorespiratory fitness and its response to incremental aerobic exercise have been incompletely evaluated in Alzheimer's disease. The aim of this analysis was to establish cardiorespiratory fitness reference values in older adults with mild to moderate Alzheimer's disease using a cardiopulmonary graded exercise testing. Ninety-seven community-dwelling older adults with mild to moderate Alzheimer's disease underwent a symptom limited cardiopulmonary graded exercise test on a cycle ergometer. Differences between sexes and between Alzheimer's disease participants with and without diagnosis of cardiovascular diseases were assessed by independent T-tests. Peak oxygen consumption was 10-20% lower than those achieved by similar clinical populations on treadmill tests. As expected, males produced significantly higher peak oxygen consumption compared to females (p =0 .02). However, the presence of concurrent cardiovascular disease did not result in statistically significant lower peak oxygen consumption compared to those without cardiovascular disease. These data provide a frame of reference for metabolic, cardiovascular, and ventilatory function during cardiopulmonary graded exercise testing performed on cycle ergometer in older adults with mild to moderate Alzheimer's disease.

Keywords: aerobic fitness; cardiopulmonary exercise testing; dementia.

Conflict of interest statement

Conflict of Interest The authors declare that they have no conflict of interest.

References

    1. Lee D C, Sui X, Ortega F B et al.Comparisons of leisure-time physical activity and cardiorespiratory fitness as predictors of all-cause mortality in men and women. Br J Sports Med. 2011;45:504–510.
    1. Kaminsky L A, Arena R, Beckie T M et al.The importance of cardiorespiratory fitness in the United States: The need for a national registry: A policy statement from the American Heart Association. Circulation. 2013;127:652–662.
    1. Salisbury D, Yu F. Aerobic fitness and cognition changes after exercise training in Alzheimer’s disease. J Clin Exerc Physiol. 2017;5:7–12.
    1. Billinger S A, Vidoni E D, Honea R A et al.Cardiorespiratory response to exercise testing in individuals with Alzheimerʼs disease. Arch Phys Med Rehabil. 2011;92:2000–2005.
    1. Anderson H S, Kluding P M, Gajewski B J et al.Reliability of peak treadmill exercise tests in mild Alzheimer disease. Int J Neurosci. 2011;121:450–456.
    1. Burns J M, Cronk B B, Anderson H S et al.Cardiorespiratory fitness and brain atrophy in early Alzheimer disease. Neurology. 2008;71:210–216.
    1. Vidoni E D, Billinger S A, Lee C et al.The physical performance test predicts aerobic capacity sufficient for independence in early-stage Alzheimer disease. J Geriatr Phys Ther. 2012;35:72–78.
    1. Vidoni E D, Gayed M R, Honea R A et al.Alzheimer disease alters the relationship of cardiorespiratory fitness with brain activity during the stroop task. Phys Ther. 2013;93:993–1002.
    1. Neder J A, Nery L E, Peres C et al.Reference values for dynamic responses to incremental cycle ergometry in males and females aged 20–80. Am J Respir Crit Care Med. 2001;164:1481–1486.
    1. Yu F, Bronas U G, Konety S et al.Effects of aerobic exercise on cognition and hippocampal volume in Alzheimerʼs disease: study protocol of a randomized controlled trial (The FIT-AD trial) Trials. 2014;15:1–13.
    1. Harriss D J, Macsween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med. 2019;40:813–817.
    1. American College of Sports Medicine,Guidelines for Exercise Testing and Prescription 10 th Edition Philadelphia, PA: Lippincott Williams, & Wilkins; 2018
    1. Morris J K, Vidoni E D, Johnson D K et al.Aerobic exercise for Alzheimerʼs disease: A randomized controlled pilot trial. PLoS One. 2017;12:e0170547.
    1. Varma V R, Watts A. Daily physical activity patterns during the early stage of Alzheimerʼs disease. J Alzheimers Dis. 2017;55:659–667.
    1. Balady G J, Arena R, Sietsema K et al.Clinician's guide to cardiopulmonary exercise testing in adults: A scientific statement from the American Heart Association. Circulation. 2010;122:191–225.
    1. Herdy A H, Uhlendorf D. Reference values for cardiopulmonary exercise testing for sedentary and active men and women. Arq Bras Cardiol. 2011;96:54–59.
    1. Viswanathan A, Rocca W A, Tzourio C. Vascular risk factors and dementia: how to move forward? Neurology. 2009;72:368–374.
    1. de la Torre J C. Alzheimer's disease is a vasocognopathy: a new term to describe its nature. Neurol Res. 2004;26:517–524.
    1. Betik A C, Hepple R T. Determinants of VO 2 max decline with aging: an integrated perspective . Appl Physiol Nutr Metab. 2008;33:130–140.
    1. Barnes D E, Yaffe K, Satariano W A et al.A longitudinal study of cardiorespiratory fitness and cognitive function in healthy older adults. J Am Geriatr Soc. 2003;51:459–465.
    1. Brown A D, McMorris C A, Longman R S et al.Effects of cardiorespiratory fitness and cerebral blood flow on cognitive outcomes in older women. Neurobiol Aging. 2010;31:2047–2057.
    1. Bouchard C, Daw E W, Rice T et al. Familial resemblance for VO 2 max in the sedentary state: the HERITAGE family study . Med Sci Sports Exerc. 1998;30:252–258.
    1. Hartman YA W, Karssemeijer EG A, van Diepen LA M et al.Dementia patients are more sedentary and less physically active than age- and sex-matched cognitively healthy older adults. Dement Geriatr Cogn Disord. 2018;46:81–89.
    1. van Alphen H J, Volkers K M, Blankevoort C G et al.Older adults with dementia are sedentary for most of the day. PLoS One. 2016;11:e0152457.
    1. Morris J K, Honea R A, Vidoni E D et Alzheimerʼs disease a systemic disease? Biochim Biophys Acta. 2014;1842:1340–1349.
    1. Wilmore J, Costill D.Physiology of Sport and Exercise 3 rd ed. Champaign, IL: Human Kinetics; 2005
    1. Ebel D L, Torkilsen C G, Ostrowski T D. Blunted respiratory responses in the streptozotocin-induced Alzheimer's disease rat model. J Alzheimers Dis. 2017;56:1197–1211.
    1. Stensvold D, Bucher Sandbakk S et al.Cardiorespiratory reference data in older adults: The Generation 100 Study. Med Sci Sports Exerc. 2017;49:2206–2215.
    1. Burns J M, Johnson D K, Watts A et al.Reduced lean mass in early Alzheimer disease and its association with brain atrophy. Arch Neurol. 2010;67:428–433.

Source: PubMed

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