Abstract
Billinger SA, Vidoni ED, Honea RA, Burns JM. Cardiorespiratory response to exercise
testing in individuals with Alzheimer's disease.
Objective
To examine exercise testing response in Alzheimer's disease (AD) and possible disease-related
change over time.
Design
Retrospective assessment of a 2-year observational study.
Setting
University medical center.
Participants
Individuals without dementia (n=50) and with AD (n=31).
Interventions
Not applicable.
Main Outcome Measures
Participants underwent a clinical dementia evaluation and performed an incremental
exercise test using a treadmill and the modified Bruce protocol at baseline and at
a 2-year follow-up. We examined oxygen consumption, minute ventilation, heart rate,
and ventilatory equivalents for oxygen and carbon dioxide at submaximal and peak exercise
intensities to determine whether the measures were different between groups or over
time.
Results
Participants with AD and those without dementia performed similarly at submaximal
effort, and both groups showed similar changes in exercise response over 2 years.
However, nondemented individuals had consistently higher values of oxygen consumption
(P≤.02) and minute ventilation at peak effort at baseline (P=.003).
Conclusions
Individuals with AD demonstrate physiologic responses to submaximal exercise effort
that are not significantly different than individuals without dementia. However, differences
are apparent at the extreme of effort.
Key Words
List of Abbreviations:
AChEI (acetylcholinesterase inhibitor), AD (Alzheimer's disease), ANOVA (analysis of variance), CDR (Clinical Dementia Rating), HR (heart rate), RER (respiratory exchange ratio), RPE (rating of perceived exertion), V̇e (minute ventilation), V̇e/V̇o2 (ventilatory equivalent for oxygen), V̇e/V̇co2 (ventilatory equivalent for carbon dioxide), V̇o2 (oxygen consumption), Vo2peak (peak oxygen consumption)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Ageing, fitness and neurocognitive function.Nature. 1999; 400: 418-419
- Cardiovascular fitness, cortical plasticity, and aging.Proc Natl Acad Sci U S A. 2004; 101: 3316-3321
- Exercise training increases size of hippocampus and improves memory.Proc Natl Acad Sci U S A. 2011; 108: 3017-3022
- Effects of aerobic exercise on mild cognitive impairment: a controlled trial.Arch Neurol. 2010; 67: 71-79
- The effects of exercise training on elderly persons with cognitive impairment and dementia: a meta-analysis.Arch Phys Med Rehabil. 2004; 85: 1694-1704
- Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial.JAMA. 2008; 300: 1027-1037
- Physical activity and memory functions: an interventional study.Neurobiol Aging. 2009; 32: 1304-1319
- Cardiorespiratory fitness and brain atrophy in early Alzheimer disease.Neurology. 2008; 71: 210-216
- Multiple defects in energy metabolism in Alzheimer's disease.Curr Drug Targets. 2010; 11: 1193-1206
- Body mass index and cognitive decline in mild cognitive impairment.Alzheimer Dis Assoc Disord. 2009; 24: 126-130
- Bone density and brain atrophy in early Alzheimer's disease.J Alzheimers Dis. 2009; 18: 777-785
- Weight loss, nutritional status and physical activity in patients with Alzheimer's disease.J Neurol. 2004; 251: 314-320
- Reduced lean mass in early Alzheimer disease and its association with brain atrophy.Arch Neurol. 2010; 67: 428-433
- Alzheimer's disease.in: Durstine J.L. Moore G.E. Painter P.L. Roberts S.O. ACSM's exercise management for persons with chronic diseases and disabilities. Human Kinetics, Champaign2009: 368-374
- Decreased platelet cytochrome c oxidase activity is accompanied by increased blood lactate concentration during exercise in patients with Alzheimer disease.Exp Neurol. 2003; 182: 421-426
- ACSM's guidelines for exercise testing and prescription.8th ed. Lippincott Williams & Wilkins, Philladelphia2010
- Mild cognitive impairment represents early-stage Alzheimer disease.Arch Neurol. 2001; 58: 397-405
- Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease.Neurology. 1984; 34: 939-944
- The Clinical Dementia Rating (CDR): current version and scoring rules.Neurology. 1993; 43: 2412-2414
- Treadmill exercise testing in an epidemiologic study of elderly subjects.J Gerontol Biol Sci. 1998; 53A: 259-267
- Aerobic capacity after traumatic brain injury: comparison with a nondisabled cohort.Arch Phys Med Rehabil. 2007; 88: 315-320
- Recommended effect size statistics for repeated measures designs.Behav Res Methods. 2005; 37: 379-384
- Body mass index and cognitive decline in mild cognitive impairment.Alzheimer Dis Assoc Disord. 2009; 24: 126-130
- Physical activity and Alzheimer's disease: from prevention to therapeutic perspectives.J Am Med Dir Assoc. 2008; 9: 390-405
- Cholinesterase inhibitors and incidence of bradycardia in patients with dementia in the Veterans Affairs New England healthcare system.J Am Geriatr Soc. 2009; 57: 1997-2003
- Normal values and ranges for ventilation and breathing pattern at maximal exercise.Chest. 1991; 100: 136-142
Article info
Footnotes
Supported by the National Institutes of Aging (grant nos. R03AG026374, R21AG029615, R01AG034614, R01AG033673, P30AG035982, R01AG034614, R01AG033673, P30AG035982), the National Institute on Neurological Disorders and Stroke (grant no. K23NS058252), and the University of Kansas Endowment Association and William and Carolie Hougland; and in part by a fellowship from the Foundation for Physical Therapy. The University of Kansas General Clinical Research Center (M01RR023940) provided essential space and nursing support.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Reprints are not available from the authors.
Identification
Copyright
© 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
