Effects of Aerobic Exercise on Brain Age and Health in Middle-Aged and Older Adults: A Single-Arm Pilot Clinical Trial
Author:
Ouyang An1234ORCID, Zhang Can123ORCID, Adra Noor123, Tesh Ryan A.123ORCID, Sun Haoqi123ORCID, Lei Dan123, Jing Jin23, Fan Peng5, Paixao Luis236ORCID, Ganglberger Wolfgang123ORCID, Briggs Logan3, Salinas Joel7ORCID, Bevers Matthew B.38, Wrann Christiane Dorothea139, Chemali Zeina12310, Fricchione Gregory123ORCID, Thomas Robert J.311, Rosand Jonathan123, Tanzi Rudolph E.123, Westover Michael Brandon123
Affiliation:
1. Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA 02114, USA 2. Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA 3. Harvard Medical School, Boston, MA 02115, USA 4. Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA 02131, USA 5. Department of Physical Therapy & Human Movement Science, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA 6. Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA 7. Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA 8. Department of Neurology, Brigham and Women’s Hospital, Boston, MA 02115, USA 9. Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA 02114, USA 10. Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA 11. Department of Medicine, Division of Pulmonary, Critical Care & Sleep, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
Abstract
Backgrounds: Sleep disturbances are prevalent among elderly individuals. While polysomnography (PSG) serves as the gold standard for sleep monitoring, its extensive setup and data analysis procedures impose significant costs and time constraints, thereby restricting the long-term application within the general public. Our laboratory introduced an innovative biomarker, utilizing artificial intelligence algorithms applied to PSG data to estimate brain age (BA), a metric validated in cohorts with cognitive impairments. Nevertheless, the potential of exercise, which has been a recognized means of enhancing sleep quality in middle-aged and older adults to reduce BA, remains undetermined. Methods: We conducted an exploratory study to evaluate whether 12 weeks of moderate-intensity exercise can improve cognitive function, sleep quality, and the brain age index (BAI), a biomarker computed from overnight sleep electroencephalogram (EEG), in physically inactive middle-aged and older adults. Home wearable devices were used to monitor heart rate and overnight sleep EEG over this period. The NIH Toolbox Cognition Battery, in-lab overnight polysomnography, cardiopulmonary exercise testing, and a multiplex cytokines assay were employed to compare pre- and post-exercise brain health, exercise capacity, and plasma proteins. Results: In total, 26 participants completed the initial assessment and exercise program, and 24 completed all procedures. Data are presented as mean [lower 95% CI of mean, upper 95% CI of mean]. Participants significantly increased maximal oxygen consumption (Pre: 21.11 [18.98, 23.23], Post 22.39 [20.09, 24.68], mL/kg/min; effect size: −0.33) and decreased resting heart rate (Pre: 66.66 [63.62, 67.38], Post: 65.13 [64.25, 66.93], bpm; effect size: −0.02) and sleeping heart rate (Pre: 64.55 [61.87, 667.23], Post: 62.93 [60.78, 65.09], bpm; effect size: −0.15). Total cognitive performance (Pre: 111.1 [107.6, 114.6], Post: 115.2 [111.9, 118.5]; effect size: 0.49) was significantly improved. No significant differences were seen in BAI or measures of sleep macro- and micro-architecture. Plasma IL-4 (Pre: 0.24 [0.18, 0.3], Post: 0.33 [0.24, 0.42], pg/mL; effect size: 0.49) was elevated, while IL-8 (Pre: 5.5 [4.45, 6.55], Post: 4.3 [3.66, 5], pg/mL; effect size: −0.57) was reduced. Conclusions: Cognitive function was improved by a 12-week moderate-intensity exercise program in physically inactive middle-aged and older adults, as were aerobic fitness (VO2max) and plasma cytokine profiles. However, we found no measurable effects on sleep architecture or BAI. It remains to be seen whether a study with a larger sample size and more intensive or more prolonged exercise exposure can demonstrate a beneficial effect on sleep quality and brain age.
Funder
McCance Center for Brain Health Glenn Foundation for Medical Research American Federation for Aging Research American Academy of Sleep Medicine Football Players Health Study (FPHS) at Harvard University Department of Defense NIH NSF Cure Alzheimer’s Fund
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